Updated
3 August 2016
Letter from the Chief Inspector of General Practice
In March 2015, we found concerns related to the management of medicines and infection control during a comprehensive inspection of South Meadow Surgery, in Eton, Berkshire. The previous inspection in March 2015 had found two breaches of the regulations relating to the safe delivery of services.
We carried out a follow up inspection of South Meadow Surgery (which included Dedworth Medical Centre) on 16 June 2016 to ensure these changes had been implemented. We found the practice was meeting the requirements of the regulations.
Following these improvements the ratings for the practice have been updated to reflect our findings.
Specifically the practice was:
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Operating safe systems in relation to management of medicines. This included appropriate arrangements in place for storing controlled drugs.
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Ensuring infection control systems were sufficient to protect patients, staff and visitors.
There was an area of practice where the provider should continue to make improvements:
We have changed the rating for this practice to reflect these changes.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
25 June 2015
The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. 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. The practice also conducted clinical audits on the management of patients with long-term conditions. The practice had system in place to identify patients with potential long term condition, and advised the patient step by step on how to minimise risk.
Families, children and young people
Updated
25 June 2015
The practice is rated as good for the care of families, children and young people. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses. Systems were in place for identifying and following-up children who were at risk, and these cases were reviewed with the health visitor regularly. A good skill mix was noted amongst the GPs with some having additional diplomas and specialist interests in areas relevant to the needs of the local population, such as geriatric medicine.
Updated
25 June 2015
The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. Clinical risk meetings, to discuss older patients with complex needs, were held with other healthcare providers including district nurses to coordinate patient care. The practice also offered vaccinations to older patients in line with current national guidelines. The practice catered to residential care homes and the practice nurse holds a flu clinic at the care homes.
Working age people (including those recently retired and students)
Updated
25 June 2015
The practice is rated as good for the care 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. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group. Cervical smear tests were offered to patients in line with national guidelines. Travel vaccinations were administered at the practice, and health promotion material was available to patients in the practice and on the website. The practice also registered students from a local college, who had a named GP.
People experiencing poor mental health (including people with dementia)
Updated
25 June 2015
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice offered in-house counselling to patients.
The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Leaflets about local support groups were available and referrals to the memory clinic for patients with dementia were made.
People whose circumstances may make them vulnerable
Updated
25 June 2015
The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability and mental health problems. It had carried out annual health checks for patients with learning disabilities and these patients were offered longer appointments. The practice provided medical services to intensive supported housing and to army families who lived in Windsor
The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary 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 normal working hours and out of hours.