Archived: Chapel Street Medical Centre

Updated 19 December 2016

Chapel Street Medical Centre is located within an old purpose built building. The building is 2 storeys with car parking facilities and disabled access with no steps. There are two treatment rooms and five consulting rooms on the ground floor and a patient/disabled toilet. On the first floor there were four administration rooms which were not accessible to patients. Public transport links were nearby.

There was a lead male GP who was the provider of the service, supported by another male and two female salaried GPs. There were two practice managers, two practice nurses and a non clinical cancer lead. An administration team of six was led by an administration manager.

This was a training practice for medical and nurse students.

The practice was open Monday to Friday from 8am until 6pm with extended working hours every Monday between 6.30pm and 8.15pm. They did not close for lunch. On the third Thursday of each month between 1pm and 4pm the practice was closed for staff training. Morning and afternoon appointments were available at various times during opening hours.

The practice list size was stable at 5758. Services were provided under a General Medical Services contract to an average practice population in one of the third most deprived areas of Tameside.

The practice were previously inspected in April 2015 when they were found to require improvement in the safe, effective and well led domains and a requirement notice was issued under the Regulations of the Health and Social Care Act 2014 - Regulation 17, Good Governance. They submitted an action plan clearly detailing the action they proposed to take to resolve the issues and attain compliance with the Regulations.

Updated 19 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chapel Street Medical Centre on 24 November 2016. Overall the practice is rated as good.

The practice was previously inspected on 21 April 2015. Following that inspection the practice was rated as good for caring and responsive services and requires improvement in safe, effective and well led.

Following this re-inspection on 24 November 2016 our key findings across all the areas inspected were as follows:

• The practice had reviewed the systems they had in place for the recording and reporting of significant events. There was now an open and transparent approach in place where significant events were regularly discussed and reviewed.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are :

• In relation to recruitment files there was no consistency to the information that was retained following checks..

• There was no alarm to call for assistance in the disabled toilets.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 December 2016

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.

• Indicators for diabetes and other long term conditions were 10% above local and national averages at 99.5%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 19 December 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. 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.

• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 79% compared to the CCG average of 81% and the national average of 81%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 19 December 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 19 December 2016

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.

• Appointments were pre-bookable six to eight weeks in advance and 48 hour non-urgent slots were also available.

• GP and nurse led appointments were available until 8.15pm every Monday evening.

• 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.

Updated 19 December 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• Indicators for the years 2015/2016 showed that 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was 8% higher than the CCG and national averages.

• Indicators for mental health were 78% which was 15% lower than the CCG and national averages. However we saw evidence that the practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 19 December 2016

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. They did not have any homeless people on their practice list.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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.