Stafford Medical Group

Updated 14 December 2017

Stafford Medical Group is located at Locking Castle, Highlands Lane, Locking Castle, Weston-super Mare, North Somerset, BS24 7DX. Stafford Medical Group also provides a part time service from Stafford Place, 4 Stafford Place, Weston-Super-Mare, BS23 2QZ. Together the locations had approximately 11,710 patients registered from around the local and surrounding areas. Patients can access information about the service at www.lockingcastlemedical.co.uk.

Patients can attend either of the practice locations although nursing services are only available from the Locking Castle location. Only GP consultations were available from Stafford Place. Neither location had passenger lifts to the first floor of the buildings. Patient care was provided on the first floor at Locking Castle and up until recently also at Stafford Place.

The practice is a partnership of two GP partners, who employ two salaried GPs, and three long term locum GPs. Five of the GPs are male and two are female. Not all of the GPs work across both locations. The practice employed an Advance Nurse Practitioner, three practice nurses and one health care assistant. The practice has a practice manager who is supported by a team of management staff, reception staff, administrators and secretaries.

Both of the practice locations are open from 8.00am, Monday to Friday. Locking Castle is open until 6.30pm each evening; Stafford Place closes at 1pm each day.

The practice has a Personal Medical Services contract with NHS England (a locally agreed contract negotiated between NHS England and the practice). The practice is contracted to deliver for a number of enhanced services including; extended hours access for patients, childhood immunisations, enhanced services for the assessment and provision of services for patients living with dementia, alcohol screening and action and the practice were involved in the unplanned hospital admission avoidance scheme.

The practice does not provide out of hour’s services to its patients, this is provided by BrisDoc. Contact information for this service is available in the practice and on the practice website.

Data from 2015/2016 that is available to the CQC shows:

The age of the patient population was slightly above the national averages for patients under the age of 18 years at 26%, the national average being 20%. For patients over 65 years the practice has 13% with the national average being 23%.

Other Population Demographics included 50% of the practice population had a long standing health condition, which was similar to the national average of 53%. Also 68% of patients were in paid work or full time education which was above the national average of 62%. Only 5% of the practice population was from a Black and Minority Ethnic background. Information from the

Index of Multiple Deprivation 2015 (IMD): showed the practice population is at 21 (the national average 21). The lower the number the more affluent the general population in the area, is.

Income Deprivation Affecting Children (IDACI): is 19% (the national average 20%)

Income Deprivation Affecting Older People (IDAOPI): is 17% (the national average 17%).

Updated 14 December 2017

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Stafford Medical Group on 8th and 9th November 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• They were knowledgeable about issues and priorities relating to the quality and future of services. They understood the challenges and were addressing them. For example, they had developed a plan to move the service forward which included reviewing facilities and succession planning for the leadership and clinical provision at the practice.

The areas where the provider should make improvements are:

• Continue with a programme of identifying and supporting carers.

• The provider should continue to keep under review the facilities and environment at Stafford Place to ensure that they are safe and fit for purpose, and to meet the needs of the patients who use it.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 July 2015

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. Longer appointments and home visits were available when needed. All these patients had regular reviews to check that their health and medication needs were being met. For those patients with the most complex needs, their GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 23 July 2015

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 mainly average for all standard childhood immunisations. Patients told us children and young patients were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 23 July 2015

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

The Quality and Outcomes Framework showed outcomes for patients were average in comparison to national figures for conditions commonly found in older patients. The practice offered proactive, personalised care to meet the needs of the older patients in its population and was responsive to the needs of patients who were living with dementia or were receiving end of life care. They offered home visits and rapid access appointments for those with enhanced needs.

Updated 23 July 2015

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 23 July 2015

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

We saw 98.7% of patients experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. They carried out advance care planning for patients with a dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. They had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for patients with mental health needs and dementia. Some staff had completed dementia friends training and the practice had a dementia lead in place.

Updated 23 July 2015

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 homeless people, travellers and those with a learning disability. The practice had carried out annual health checks for patients with a learning disability and 56% of these patients had received a follow-up. They offered longer appointments for patients with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients and prioritised completing housing forms for the homeless. 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.