Archived: The Practice Rushey Mead

Updated 2 July 2015

The Practice Rushey Mead is a GP practice which provides a range of primary medical services under a GMS contract to around 2500 patients from a surgery in Leicester city. The practice’s services are commissioned by Leicester City Clinical Commissioning Group (CCG). At the time of our inspection the service was provided by two locum GP’s, a practice nurse and a part time healthcare assistant. They are supported by a practice manager and reception and administration staff.

Local community health teams support the GPs in provision of maternity and health visitor services.

The Practice Rushey Mead is a service operated by The Practice Surgeries Limited from a location registered with the Care Quality Commission (CQC) at 8 Lockerbie Walk, Leicester LE4 7ZX.

We reviewed information from Leicester City clinical commissioning group (CCG), and Public Health England which showed that the practice population had similar deprivation levels compared to other practices within the CCG but higher than the average for practices in England.

When the surgery is closed the out of hours service is provided to Leicester City, Leicestershire and Rutland by Central Nottinghamshire Clinical Services.

Updated 2 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Practice Rushey Mead on 8 January 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led services. It was also good for providing services for all the population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said they found it easy to make an appointment but felt there was a lack of continuity due to a current lack of permanent GP’s. Urgent appointments were available on 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure information relating to the control of substances hazardous to health (COSHH) is up to date.

• Implement multi disciplinary meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 July 2015

The practice is rated as good for the care of people with long-term conditions. Patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. The higher risk patients had a care plan in place and a structured annual review to check that their health and medication needs were being met.

The practice had prioritised the management of long-term conditions as the prevalence of patients registered with the practice with a diagnosis of asthma, atrial fibrillation, dementia, heart failure, hypertension and chronic heart disease was higher than the national average.

There was an arrangement in place in order for patients who needed to attend anticoagulation clinics to go to a local surgery in order to avoid travelling to hospital.

Flu immunisations were available annually to all eligible patients with long term conditions.

Updated 2 July 2015

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. Appointments were available outside of school hours.

The practice provided 24 hour baby checks for newborn babies, as well as offering six week checks for mothers and babies.

There was a protocol in place in order for children to be given on the day appointments.

Young people were offered chlamydia screening kits from the nurse or GP and these were also available from reception. This was also offered as part of the new patient health check.

Updated 2 July 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 personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in admissions avoidance. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The Better care Fund initiative involves creating care plans for the 10% of patients at highest risk of admission, meaning the majority of elderly patients would have a care plan in place.

The practice supported three care homes and had a palliative care register.

Updated 2 July 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. The practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. Evening appointments were available once a week and were pre-bookable six weeks in advance. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.

NHS health checks were available to patients between 40 years and 74 years, and eligible patients were invited by letter, text message or opportunistically when they attended the practice. Eligible patients were identified by means of a pop up alert on their record and reception staff were trained to promote and offer this service in order to screen as many patients as possible.

Updated 2 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients experiencing poor mental health had received an annual physical health check.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Staff had received training on how to care for people with mental health needs and dementia. Longer appointments were available for patients experiencing poor mental health.

IAPT (Improving Access to Physiological Therapies) held clinics every two weeks at the practice for patients experiencing poor mental health.

Updated 2 July 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 with a learning disability. It had carried out annual health checks and offered longer appointments for people with a learning disability.

The practice 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.