Beechwood Surgery

Updated 29 December 2017

Beechwood Surgery is located in a purpose built premises in Warley, Brentwood.

• The practice provides services at Pastoral Way, Brentwood.
• There are approximately 12,457 patients registered at the practice.
• The practice is registered with the Care Quality Commission as a partnership, with four GP partners and three salaried GP's. The practice employs three practice nurses, one health care assistant, practice manager and a team of administrative and reception staff who support the practice.
• The practice is open between 8am and 6.30pm on weekdays with surgeries running from 8.30am to 6.30pm.
• Beechwood Surgery is a teaching practice with one GP accredited trainer. The practice offers training opportunities and currently hosts one trainee GP.
• When the practice is closed patients are advised to call the surgery and be directed. Alternatively they may call the national NHS 111 service for advice. Out of hours provision is commissioned by Basildon and Brentwood CCG, and provided by IC24.
• The practice has a clear well produced comprehensive website. It provides details of services and support agencies patients may find useful to access.

Updated 29 December 2017

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (This practice was previously inspected February 2015 and rated as good).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Requires Improvement

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Beechwood Surgery on 28 November 2017. We carried out a comprehensive inspection as part of our inspection programme under Section 60 of the Health and Social Care Act 2008. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients reported difficulty accessing the telephone and found it difficult to book an appointment.
• The practice sought and acted on feedback from patients and had listened and responded to surveys completed. However patients reported reduced satisfaction with access to appointments and the telephone system.
• The practice was clean and tidy and staff had reviewed infection prevention control and policies.
• Patient safety and medicine alerts were shared amongst the clinical team and were consistently actioned and recorded.
• The practice maintained a good relationship with its patient participation group (PPG) who were proactive and responsive to the local populations needs.
• We saw staff treated patients with kindness and respect, and maintained patient dignity and information confidentiality.
• Training had been completed by all clinical members of staff however we found members of the non clinical team had not carried out refresher training for safeguarding. We found non clinical staff were aware of local protocols and had adequate knowledge to safeguard vulnerable adults and children. Since the inspection the practice have provided the remaining non clinical staff with time to complete their training.
• The practice had effective systems in place for temporary staff to allow them to carry out their roles efficiently.

The areas where the provider should make improvements are:

• Ensure there is an effective process to identify carers to enable support and advice to be offered to those that require it.
• Ensure staff complete refresher training when required.
• Continue to improve on patient satisfaction levels relating to access to service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 May 2015

This practice is rated as good for the care of people with long term conditions. The practice had effective arrangements for making sure that people with long term conditions were invited to the practice for annual or half yearly reviews of their health and medication to ensure that their treatment remained effective. Appointments were available with the practice nurses for annual health checks and reviews for long term conditions such as diabetes and respiratory conditions including asthma and chronic obstructive pulmonary disease (COPD). When needed, longer appointments and home visits were available. For those people with the most complex needs the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Patients had access to pre-bookable routine appointments on Saturday mornings. Patients told us staff supported and provided them with advice to help them manage their health.

Updated 28 May 2015

The practice is rated as good for the population group of families, children and young people. Appointments could be booked online, in person or by telephone. Appointments could be booked up to six weeks in advance.

Information and advice was available to promote health to women before, during and after pregnancy. The practice offered pre-conception services and post-natal check ups for babies and mothers with fortnightly appointments and clinics. The practice monitored the physical and developmental progress of babies and young children. Appointments were made available outside of school hours wherever possible.

There were arrangements for identifying and monitoring children who were at risk of abuse or neglect. Records showed that looked after children (such as those in foster care / under the care of the Local Authority), those subject to child protection orders and children living in disadvantaged circumstances were discussed, including any issues shared and followed up, at monthly multi-disciplinary meetings. GPs and nurses monitored children and young people who had a high number of A&E attendances or those who failed to attend appointments for immunisations and shared information appropriately. Staff were trained to recognise and deal with acutely ill babies and children and to take appropriate action.

There was information available to inform mothers about all childhood immunisations, what they are, and at what age the child should have them as well as other checks for new-born babies. Staff proactively followed up patients who failed to attend appointments for routine immunisation and vaccination programmes.

Information and advice on sexual health and contraception was provided during GP and nurse appointments.

Updated 28 May 2015

This practice is rated as good for the care of older people. Patients over the age of 75 years had a named accountable GP who was responsible for their care and treatment. The practice identified patients who were at risk of avoidable unplanned hospital admissions. These patients were included on the practice’s ‘unplanned admissions avoidance’ list to alert staff to people who may be more vulnerable. Regular multidisciplinary team meetings were held with other health and social care professionals to support patients and ensure that they received coordinated care and treatment.

The GPs carried out visits to people’s homes if they were unable to travel to the practice for appointments. The practice provided a range of health checks for patients aged 75 years and over. Seasonal flu vaccination and shingles vaccination programmes were provided and the practice was performing well in ensuring that patients received these vaccinations. Longer appointments were available if needed and pre-booked appointments were available on Saturday mornings. Patients with one or more long-term medical condition in the over 75 years population group and those who were identified as being vulnerable were included on a frailty register and had individualised care plans, which were reviewed every three months by the patient’s named GP.

The practice identified people with caring responsibilities and those who required additional support which was recorded on their patient record. Patients with caring responsibilities were invited to register as carers so that they could be offered support and advice about the range of agencies and benefits available to them.

Updated 28 May 2015

The practice is rated as good for the population group of working-age people (including those recently retired and students). The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. Appointments could be booked online, in person or by telephone. Appointments could be booked up to six weeks in advance. Pre-bookable appointments were available on Saturday mornings.

Information about annual health checks for patients aged between 40 and 75 years was available within the practice and on their website. The Healthcare assistant or nurses offered these health checks at times to suit the patients. The practice provided travel advice and vaccination through appointments with the practice nurse team. Information on the various vaccinations available including diphtheria, tetanus, polio and hepatitis A was available on the practice website. When patients required referral to specialist services, including secondary care, patients were offered a choice of services, locations and dates. These referrals were made in a timely way and monitored to ensure that patients received the treatments they needed.

Updated 28 May 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). People experiencing poor mental health had received an annual physical health check. The practice regularly worked with multidisciplinary teams to support people experiencing poor mental health including those with dementia. The practice provided dementia screening services and referrals were made to specialist services as required.

Patient referrals were made to appropriate services such as psychiatry and counselling, including The Improving Access to Psychological Therapies (IAPT) and referrals to Child and Adolescent Mental Health Services (CAMHS). The practice rented space to some of these providers, which facilitated access for patients.

The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations including MIND. Patients were provided with information how to self-refer should they wish to receive counselling.

Updated 28 May 2015

This practice is rated as good for the care of people living in vulnerable circumstances. The practice had a register of patients who had learning disabilities. All patients with learning disabilities were invited to attend for an annual health check and 91% of patients had received these checks within the previous twelve months.

The practice regularly worked with multidisciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in and out-of-hours.