Archived: Cape Road Surgery

Updated 21 December 2016

Cape Road Surgery provides primary healthcare services to patients in Warwick and the surrounding villages of Leek Wootton, Haseley, Hatton, Budbrooke, Hampton Magna, Hampton-on-the-Hill, Norton Lindsay, Sherbourne and Barford. The practice has a General Medical Services (GMS) contract with NHS England. The practice is based in Warwick town centre in a converted townhouse which has been extended to better suit this purpose. Disabled access is accommodated by an entrance ramp, ground floor consultation rooms and a disabled toilet. There is no parking attached to the practice and there is limited parking available in the surrounding area due to its town centre location.

Cape Road Surgery has a patient list size of approximately 4,622 including some patients who live in one local care home. A higher than average percentage of the practice’s patient group are between 40 and 80 years of age, and a lower than average number are young families. There is a low level of social deprivation within the practice’s catchment area.

The practice has expanded its contracted obligations to provide some enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients. For example, the practice offers the childhood vaccination and immunisation scheme, extended hours access, facilitating timely diagnosis and support for people with dementia, and minor surgery.

The clinical team consists of a male and a female GP partner and one female salaried GP, a nurse practitioner, a nurse and a healthcare assistant. They are supported by a practice manager, five receptionists and two administrative staff.

Cape Road Surgery’s reception operates on weekdays from 8.30am to 12.30pm and 1.30pm to 6pm. Appointments are available between these times. The practice telephone lines continue to direct patients to staff between 8am and 8.30am, 12.30 and 1.30pm, and 6pm to 6.30pm. There are arrangements in place to direct patients to the out-of-hours NHS 111 service when the practice is closed. Extended hours appointments are offered on Monday evenings from 6.40pm to 8.10pm, excepting every fifth week when extended hours appointments were offered on a Saturday morning from 9.10am to 10.40am instead.

Updated 21 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cape Road Surgery on 5 July 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had a suitable system to report and record significant events.

• Procedures were in place for monitoring and managing risks to patient and staff safety.

• The practice delivered care in line with relevant and current evidence based guidance and standards. Systems were in place to keep all clinical staff up to date with current guidelines.

• Practice staff had the skills, knowledge and experience to deliver effective care and treatment.

• Staff were accommodating and courteous to patients, treating them with dignity and respect.

• Material about services available was accessible in simple formats that could be easily understood.

• Patient comment cards informed us that people were able to get appointments when they needed them.

• The practice had a vision to maintain their patients’ health throughout their lives using traditional personalised care. There were values in place of openness, fairness, respect and accountability.

• The leadership structure helped to ensure that staff were adequately supported by management. There were regular team meetings involving all staff which provided an opportunity to raise any issues. The partners and practice manager were open with staff and made time to deal with concerns.

• Systems were in place to ensure the practice complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Blank prescription forms should be monitored during use.

• Measures should be implemented to identify and record the collection of prescriptions for controlled drugs, and to record the destruction of prescriptions not collected.
• The provider should satisfy itself that staff follow nationally recognised guidance when undertaking chaperoning duties.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 December 2016

The practice is rated as good for the care of people with long-term conditions.

• The practice nursing team offered a range of chronic disease clinics. The nurse team maintained its competence in chronic disease management by attending regular training on specific conditions such as diabetes and asthma.
• The practice maintained registers for patients with a number of long term conditions. Registers were used to monitor and improve care, for example by identifying when patients were due for annual reviews.
• The practice offered support and signposted services to those at risk of developing a long-term condition and those requiring advice on their diet, smoking and alcohol cessation.
• The practice held monthly meetings with the district nurses and community matron to discuss patients receiving treatment, and also carried out reviews of unplanned admissions.
• One of the partners had attended training in advanced care planning and end of life care. This had helped the practice to offer a better service to those approaching the end of life.

Updated 21 December 2016

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

• The practice had a high uptake of childhood immunisations, with many achieving a completion rate of 100%. The practice contacted any patients who did not attend for childhood immunisations and liaised with Child Health Services.
• Same day appointments were available for children, as were appointments outside of school hours. The premises were suitable for children and babies.
• The practice used an alert system to ensure staff were aware of any safeguarding concerns regarding children. There was a lead GP for children’s safeguarding who liaised with health visitors to discuss any concerns.

Updated 21 December 2016

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

• Care was tailored to meet the needs of the older people in the practice population.
• GPs made home visits to older patients who had difficulty attending the practice. Home visits were also available for older people to receive the flu vaccination.
• Same day appointments were available for older people whose health required an urgent consultation.
• The practice engaged with an Age UK coordinator to support older people. Health checks were offered to patients aged over 75 to identify health problems or areas where further support may be required.
• The GPs and nurse practitioner had completed training in frailty to help identify and support older people whose health was deteriorating.

Updated 21 December 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice offered appointments during extended hours on Monday evenings and every fifth week on a Saturday morning instead. This helped to ensure that appointments were accessible to those patients who had difficulty attending the practice during working hours.
• Patients were able to access appointment booking and repeat prescription ordering online.
• Clinical staff offered telephone appointments for the convenience of working aged patients.
• The practice provided health promotion and screening to accommodate this age group. For example, health checks for patients aged over 40 were available.

Updated 21 December 2016

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

• 98% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was significantly higher than the CCG average of 85% and the national average of 84%.
• 87% of patients experiencing poor mental health had their alcohol consumption recorded in the previous year, which was slightly lower than the CCG average of 93% and the national average of 90%.
• Patients experiencing poor mental health were given information about how to access support groups and voluntary organisations. For example, Improving Access to Psychological Therapies counsellors held clinics at the practice.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. For example, the practice held a quarterly mental health team meeting which was attended by the community psychiatric nurse and psychiatrist.
• The practice maintained a mental health register and performed physical and mental health annual reviews for these patients.

Updated 21 December 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice had several homeless patients registered, and liaised with social services regarding their needs. Homeless patients were reviewed flexibly as and when required, as their circumstances meant they were not always contactable or able to book and maintain appointments.
• Longer appointments were available for patients with a learning disability.
• There was disabled access, a hearing loop and information about available translation services was displayed in the patient waiting area.
• The practice held a registers of a number of circumstances that may make patients vulnerable. For instance, there was a carers register and alerts informed staff if a patient was also a carer. The registers were used to manage and offer support to patients.
• Staff had received safeguarding training and knew how to recognise signs of abuse in children and adults.