Archived: Dr AS Coutts and Partners Also known as Four Oaks Medical Centre

Updated 10 March 2016

Four Oaks medical centre is one of the larger general practices in the Sutton Coldfield area and is located in the centre of Mere Green. The practice is located on the first floor of Carlton house. Access to the practice is by lift or stairs.

There are eight GPs in total, 5 male and 3 female and they are supported by three practice nurses, a health care assistant and a phlebotomist. The practice manager is supported by a team of administration and reception staff. The practice serves a registered patient population of approximately 11,900. Data shows a low level of income deprivation among the registered population.

The practice supports training GPs. The practice had a qualified doctor training to be a GP working with them at the time of the visit.

The practice was open between 8am and 6.30pm Tuesday, Thursday and Friday 8am to 1.30pm Wednesday and 8am to 8.30pm on Friday. Appointments were from 8am to 12pm every morning and 2.30pm to 6pm daily and up to 8.30pm on Mondays. In addition to pre-bookable appointments that could be booked up to one month in advance, urgent appointments were also available for people that needed them. When the practice is closed the Badger Group (GP Out of Hours Services) covers the service.

Updated 10 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr AS Coutts and Partners

Also known as Four Oaks Medical Centre on 20 January 2016. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• The practice was proactive in the management of long term conditions.

• Information about services and how to complain was available. The practice actively sought patient views about improvements that could be made to the service and worked with the Patient Participation Group (PPG) to do this.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• The practice proactively sought to educate their patients to manage their medical conditions and improve their lifestyles. Additional in house services were available and delivered by staff with advanced qualifications, skills and experience.
• The practice used audits and had shared information from one of their audits with other practices to promote better patient outcomes.
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 March 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.

• The practice had improved the patient pathway for diabetes management so it was a team approach and focused on holistic patient care.

• 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.

Patients with long-term conditions who were at risk were placed on the practice’s avoiding unplanned admissions register.

Updated 10 March 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.

• Immunisation rates were above CCG and national rates for all standard childhood immunisations.

• 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 10 March 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were consistently above the national average for conditions commonly found in 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.

• The practice used specific templates for the general older person health check that prompted a falls assessment, dementia screening, carer details and that also offered carers’ wellbeing/health checks.

Updated 10 March 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.

• 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 10 March 2016

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 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 10 March 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 including homeless people, travellers and those with a learning disability.

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

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• 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.