Background to this inspection
Updated
27 November 2019
Clifton Court Medical Practice is located at Victoria Road, Darlington County Durham DL15JN. . The surgery is situated in a purpose-built health care facility in central Darlington.
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.
Clifton Medical Practice is situated within the NHS Darlington Clinical Commissioning Group (CCG) and provides services to 12045 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.
The provider is a partnership of five GPs (three female and two male) and registered with the CQC in April 2013. The practice is part of a primary care network and as such is developing services in collaboration with other practices in the locality. This includes extended access to GP appointments where appointments are available on evenings and weekends.
The National General Practice Profile states that 4.3% of the practice population is from black, mixed or other non-white ethnic groups. Information published by Public Health England, rates the level of deprivation within the practice population group as three, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is 77 years compared to the national average of 79 years. Female life expectancy is 82 years compared to the national average of 82 years.
Clifton Court Medical Practice is a teaching practice providing placements and teaching for fifth year medical students.
Updated
27 November 2019
We carried out an announced comprehensive inspection at Clifton Court Medical Practice on 15 October 2019 as part of our inspection programme. We carried out an inspection of this service due to the length of time since the last inspection. Following our review of the information available to us, including information provided by the practice, we focused our inspection on the following key questions: Effective and Well led
Because of the assurance received from our review of information we carried forward the ratings for the following key questions: Safe, Caring and Responsive
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
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We have rated this practice as good overall and good for all population groups. We found the practice to be outstanding in providing well led services because
the culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
- The leaders at the practice were proactive and collaborated effectively with local stakeholders, including in the sharing of new developments digitally. Staff well-being was an important focus in the team and the leaders were highly regarded by their staff. The practice had introduced numerous support mechanisms to sustain and protect staff. The practice had a culture of collaboration and sharing innovation with other practices in the locality. They were able to demonstrate quality improvement based on their actions.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care
People with long term conditions
Updated
23 July 2015
The practice is rated as good for the care of people with long term conditions. People with long term conditions were monitored and discussed at multi-disciplinary clinical meetings so the practice was able to respond to their changing needs. The clinical team met regularly to discuss NICE guidelines and clinical cases. This ensured that patients received the most appropriate treatment. Information was made available to out of hours providers for those on end of life care to ensure appropriate care and support was offered. The practice had a chronic disease management recall system for patients with chronic conditions including cardiovascular disease, asthma, hypertension, strokes, diabetes and thyroid disease. This included an annual health check at a nurse led clinic to ensure their conditions were appropriately monitored. Patients were involved in making decisions about their care. The practice routinely followed up non-attenders to ensure they had the required routine health checks.
Families, children and young people
Updated
23 July 2015
The practice is rated as good for the care of families, children and young people. Systems were in place to identify children who may be at risk, those on a child protection plan or looked after children. The practice monitored levels of children’s vaccinations and immunisation rates were in line with the national average. Regular family planning clinics were available. The practice ensured small children who were ill would always be seen on the same day. The appointment system offered flexibility with extended opening hours giving access to both GPs and nursing staff outside of school hours.
Updated
23 July 2015
The practice is rated as good for the care of older people. The practice held multi-disciplinary meetings to ensure the needs of those with chronic conditions or end of life care were met. Care plans were tailored to meet to individual needs and circumstances. Patients and their carers were involved in this process. The practice also undertook weekly visits to two residential nursing homes, one of which had a large elderly mental illness unit. The practice undertook monthly multi-disciplinary meetings with the local geriatrician to ensure that care for these vulnerable older patients at the unit was co-ordinated effectively. The over 75’s had a named GP. Information was shared with other services, such as out of hours services. Nationally reported data showed the practice had good outcomes for conditions commonly found in older people.
Working age people (including those recently retired and students)
Updated
23 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 population had been identified and services met these needs. Routine appointments could be booked in advance, or made online. Repeat prescriptions could be ordered online. Longer appointments and extended hours opening were available.
Some of the clinics began at 7.30am two mornings a week and on one evening a week there was a late clinic with a choice of GP and nursing appointments until 7.10pm. The practice was also working alongside Primary Healthcare Darlington to improve access as part of the Prime Ministers Challenge Fund, with appointments at overflow clinics and weekend clinics being available.
People experiencing poor mental health (including people with dementia)
Updated
23 July 2015
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). National data showed the practice performed well in carrying out additional health checks and monitoring for those experiencing a mental health problem. For instance, 99% of patients diagnosed with dementia had received a face to face review of their care in the last year, this compares to a national average of 83%. The practice also undertook weekly visits to a residential nursing home with an elderly mental illness unit, where many of the residents had dementia. They worked with other mental health care professionals to ensure that care for vulnerable older patients in the unit was co-ordinated effectively. The practice identified and referred patients in need of mental health support to the Primary Care Mental Health service. The practice also directed patients to outside agencies, such as MIND, for additional advice and support. Regular reviews were offered to all patients on the practices mental health register.
People whose circumstances may make them vulnerable
Updated
23 July 2015
The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice had a register of those who may be vulnerable, including those who were homeless or from travelling communities, who were offered annual health checks when they visited the practice. Patients or their carers were able to request longer appointments if needed. The practice had a register for looked after or otherwise vulnerable children and worked with school nurses to follow up if any routine appointments were missed. The practice supported patients engaged with substance reduction services by working with pharmacy colleagues to ensure that patients followed their medication regime. The computerised patient plans were used to flag up issues where a patient may be vulnerable or require extra support, for instance if they were a carer. Staff were aware of their responsibilities in reporting and documenting safeguarding concerns.