Deddington Health Centre Also known as Dr Ruddock & Partners

Updated 24 October 2016

Deddington Health Centre has a patient list of 9784. It is located in the village of Deddington, Oxfordshire and serves local villages and rural communities. There is a higher proportion of patients between 40 and 70 years old than the national average. The number of patients under 30 is significantly lower than the national average. The surgery was purpose built in 1971 and was extended in the early 1980s. It was accessible for disabled patients and those with limited mobility. There was parking including designated disabled parking. There were some bus services running to local villages enabling some patients to travel by public transport.

The practice is registered to provide services from: Deddington Health Centre, Earls Lane, Deddington, Oxon, OX15 0TQ.

There are four GP partners at the surgery and two salaried GPs, including three female and three male GPs. There are three female practice nurses and a female healthcare assistant. A number of administrative staff and a practice manager support the clinical team.

The practice was open between 8am and 6.30pm Monday to Friday and appointments were available during these times. There were no extended hours appointments. When the practice was closed patients could access out of hours GP services by calling 111. This was clearly displayed on the practice’s website.

The practice is registered for the correct regulated activities in relation to the services it provides and there is a registered manager in post.

This is a training practice and there was one GP in training working at the practice.

Updated 24 October 2016

Letter from the Chief Inspector of General Practice

We carried out a desktop review of Deddington Health Centre in September 2016. We requested information from the practice to be sent to us so we could undertake a review of evidence offsite. This was following a comprehensive inspection in January 2016 where we identified concerns with the monitoring of patient care and treatment and staff awareness of the Mental Capacity Act 2005. We issued a requirement notice and rated the practice as requires improvement in the effective domain. The practice sent us an action plan stating what they were going to do to make improvements. At this inspection we found:

• The monitoring of patient care and treatment had improved following an audit of diabetes related indicators as well as an audit of patients on Lithium (a high risk medicine).
• The process for medicine reviews had been changed to ensure patients received a review in a timely way.
• The nursing team had received training on the Mental Capacity Act 2005 and guidance had been introduced for mental capacity assessments.

During the previous inspection, we also reported on areas where improvements should have been considered. At this inspection we found that the practice had acted on these findings.

The practice had implemented a new alerts policy and vulnerable patients already registered were clearly flagged up on the records system. Overdue appraisals had also been brought up to date.

This report only covers our findings in relation to these requirements. You can read the report from out last comprehensive inspection by selecting the ‘all reports’ link for Deddington Health Centre on our website www.cqc.org.uk 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 2016

The practice is rated as good for the care of people with long-term conditions.

• The practice followed guidance in the management of chronic diseases.
• Patients at risk of hospital admission were identified and had care plans written where appropriate.
• The practice achieved 94% on its quality outcomes framework scores (QOF) in 2015. QOF is a quality system to measure the performance and quality of patient care and treatment.
• The care of long term conditions was audited to identify where improvements in the management of a specific condition could be made.
• Longer appointments and home visits were available when needed.
• There was a process to offer a structured review to check patients’ health
• The monitoring of patients on long term medicines was not always robust. The practice could not provide data on the number of patients who had up to date reviews of their medicines while on repeat prescriptions of less than four medicines.
• 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.
• Medicines were dispensed and available from the practice via automated dispensing 24 hours a day.

Updated 3 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. Childhood immunisation rates for the vaccinations given to under two year olds were 95% and for five year olds they were 98%. This was compared to the overall CCG average of 89%. Staff were aware of the circumstances and rights when gaining consent from patients under 16.
• Baby changing facilities were available but these were located away from patient accessible areas. They were not clearly signed.
• GPs worked with midwives and health visitors in the provision of care.

Updated 3 March 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 patients in its population.
• Care plans were available for patients deemed at high risk of unplanned admissions.
• Access for patients with limited mobility was good including for those with mobility scooters.
• There were named GPs for this group of patients.
• Medicines were dispensed and available from the practice via automated dispensing 24 hours a day. There were safe systems to enable local collections and deliveries of medicines to patients living in isolated communities with limited mobility.
• Screening for conditions which patients in this population group may be at risk of was provided, such as dementia.

Updated 3 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.
• There were no extended hours appointments available.
• Patient feedback on the availability of appointments from the national survey and on the day of inspection was very positive.
• Phone consultations were offered to patients.
• Online appointment booking was available.

Updated 24 October 2016

In January 2016 we found that a practice-led audit had identified that not all patients on lithium had received their medicine review but not action to mitigate this was undertaken promptly. This left patients at risk.

In September 2016 a recent audit of patients on lithium showed that all patients prescribed this medicine now had a medicine review.

Updated 3 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 those with a learning disability.
• However, flags on the computer records system did not always code vulnerable patients correctly to ensure staff could identify them.
• The practice offered longer appointments for vulnerable patients.
• GPs 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.