Whetstone Lane Medical Centre - Katherine V Gregson

Updated 5 August 2016

Whetstone Lane Medical Centre is situated in a deprived area of Wirral and is registered with CQC to provide primary care services, which include access to GPs, family planning, ante and post-natal care.

The practice has a General Medical Services (GMS) contract with a registered list size of 8504 patients (at the time of inspection). The practice has three male GP partners, two female GP partners, two female salaried GPs and a male salaried GP, four practice nurses, a healthcare assistant, a practice manager and a number of administration and reception staff. The practice is a teaching practice for medical students.

The practice is open 8am to 6.30pm Monday to Friday and provides extended hours Monday 6.30pm to 8pm and Thursday mornings from 7am to 8am. Appointments are bookable in person, on line or by telephone. Home visits and telephone consultations are available for patients who required them, including housebound patients and older patients. There are also arrangements to ensure patients received urgent medical assistance when the practice was closed. Out of hours patients are asked to contact the NHS 111 service to obtain healthcare advice or treatment.

Updated 5 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Whetstone Lane Medical Centre – CM Pleasance on 26 May 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 been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.

• Patients said they found it easy to make an appointment and 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.

  We saw areas of outstanding practice:

• The practice carried out monthly audits of patients on the mental health register who were prescribed antipsychotic drugs this was to ensure they had received their medication. Actions were taken with any issues identified by the audit, such as discussing with the patient or contacting their community mental health worker.

• The practice worked closely with local homeless shelters and specialist homelessnessnurses to ensure this vulnerable group of patients had access to health services. The practice worked closely with patients and the health and social care professionals supporting them to ensure their health and social care needs were met. For example, the practice monitored missed appointments for this group of patients and contacted health and social care professionals to ensure they were safe.

• The practice registered and provided emergency appointments to homeless patients. The chief executive of one of the local homeless shelters and specialist homelessness nurses told us the practice worked proactively with them to ensure some of the most marginalised people in society received appropriate and safe healthcare.

• The practice and the PPG had worked to engage patients who were homeless including arranging meetings when homeless patients were more likely to attend.

• The practice had a policy of not turning away homeless patients who presented with aggressive behaviour. If a situation occurred the staff would contact the homeless shelters or specialist homelessness nurses to arrange for them to attend to support the patient.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 5 August 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.

• 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.

Updated 5 August 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.

• 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 5 August 2016

The practice is rated as good for the care of 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 carried out regular consultations for patients living in care homes. A representative from one of the care homes told us the practice proactively managed the care and treatment of patients living at the care home. This action had resulted in a reduction of urgent appointments being required and had also ensured patients received continuity of care.

Updated 5 August 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 5 August 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 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.

• The practice carried out monthly audits of patients on the mental health register who were prescribed antipsychotic drugs this was to ensure they had received their medication. If any issues were identified by the audit appropriate action was taken, such as discussing this with the patient or contacting their community mental health worker.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 5 August 2016

The practice is rated as outstanding 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 and those with a learning disability.

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

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice worked closely with local homeless shelters and specialist homelessness nurses to ensure this vulnerable group of patients had access to health services. The practice worked closely with patients and the health and social care professionals supporting them to ensure their health and social care needs were met. For example, the practice monitored missed appointments for this group of patients and contacted health and social care professionals to ensure they were safe. The practice registered homeless patients and provided emergency appointments to reflect the transient nature of this patient group’s lifestyle. The chief executive of one of the local homeless shelter and specialist homelessness nurses told us the practice worked proactively with them to ensure some of the most marginalised people in society received appropriate and safe healthcare.

• The practice and the PPG had worked to engage patients who were homeless including arranging meeting when homeless patients were more likely to attend.

• The practice had a policy of not turning away vulnerable patients who may appear aggressive. If a situation occurred the staff would contact the homeless shelters or specialist homelessness nurses to arrange for them to attend to support the patient.

• 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.