The Rosemary Medical Centre

Updated 12 April 2016

The Rosemary Medical Centre was inspected on Thursday 18 February 2016. This was a comprehensive inspection.

The practice is situated in the Parkstone area of Poole. The practice provides a primary medical service to 7,880 patients of a diverse age group. The practice is both training and teaching practice for medical students and GP registrars.

There was a team of five GPs partners, three male and two female. Some worked part time and some full time. Partners hold managerial and financial responsibility for running the business. The team were supported by a practice manager, a nurse practitioner, three practice nurses, two healthcare assistants and additional administration staff.

Patients using the practice also had access to community nurses, and health visitors who are based at the practice. Other health care professionals visit the practice on a regular basis.

The practice is open between 8. am - 6.30pm Monday to Friday. Appointments can be offered anytime within these hours. Extended hours appointments are offered on Saturday mornings 8am to 12 noon for pre bookable appointments.

Outside of these times patients are directed to contact, emergency calls are handled by Urgent Care Service Dorset & Somerset (UCSDS). The South West Ambulance Service Foundation Trust out of hour’s service by using the NHS 111 number.

The practice offered a range of appointment types including book on the day, telephone consultations and advance appointments.

The practice had a General Medical Services (GMS) contract with NHS England.

The practice provided regulated activities from a single location at 2 Rosemary Gardens, Poole. We visited this location during our inspection.

Updated 12 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Rosemary Medical Centre on 18 February 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
• Patients said they found it easy to make an appointment with a named GP and that 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:

The provider should carry out regular audits to assess monitor and improve the quality of service and use the information to make improvements and demonstrate that they have been made.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 April 2016

The practice is rated as good for the care of patients 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 percentage of patients with diabetes, on the register, who have had influenza

  Immunisation in the preceding 1 August to 31 March 2015 was 100% which was better than the national average of 94.45%.

• 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.

• The practice undertook regular surveys from people with long-term conditions to ensure that they were maintaining high quality care or to identify areas were they could improve.

Updated 12 April 2016

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

• 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 patients who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• 79.79% of patients diagnosed with asthma, on the register, had received an asthma review in the last 12 months compared to the national average of 75.35%

• Patients told us that children and young patients 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 82.48%, which was comparable to the national average of 81.83%.

• 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, and health visitors

Updated 12 April 2016

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

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

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

• The practice employed a nurse to specifically look after patients aged over 75 years where they had been discharged from hospital, attended the local accident and emergency department or had frequent contact with the practice. This was to facilitate any changes with their medication, address their concerns and/or improve their situation to avoid further crises.

Updated 12 April 2016

The practice is rated as good for the care of working-age patients (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 12 April 2016

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

• 92.11% of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which is worse than the national average of 84.01%

• 100% of patients diagnosed with mental health issues had received a face to face review within the last 12 months. This was better than the national average of 84%.

• 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.

• The practice had a carer’s lead to improve the service and support provided to carers.

Updated 12 April 2016

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

• The practice held a register of patients living in vulnerable circumstances including 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 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.