Archived: Redwood House Surgery

Updated 23 April 2015

Redwood House Surgery is located in a converted detached house in a small town in Berkshire. It holds a General medical services (GMS) contract to provide primary medical services to just over 6000 registered patients.

Care and treatment is led by three GPs; one male and two female. They are supported by a practice manager, two practice nurses, administration and reception staff; a total of 14 staff.

The practice has a lower proportion of patients in the 15 to 34 year age group and higher in the age groups: 5 to 14 years and 40 to 49 years compared to the local average. The practice serves a population which is significantly more affluent than the national average.

The practice takes an active role within the Windsor, Ascot and Maidenhead Clinical Commissioning Group (CCG) to develop services in the area.

The practice has opted out of providing out-of-hours services to its own patients. There are arrangements in place for patients to access care from an out-of-hours provider, 111.

We visited the practice location at Redwood House Surgery Cannon Lane, Maidenhead Berkshire SL6 3PH.

Updated 23 April 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Redwood House Surgery on 12 March 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for all the key questions and all the population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 April 2015

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. 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. Ninety nine patients who had been identified all had a care plan in place to manage their needs. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. The practice had identified 286 diabetic patients and proactively identified diabetes early. The majority of patients with long term conditions had received annual reviews of their condition: 91.7% of patients with chronic obstructive pulmonary disease (lung disease) and 72.5% of patients with asthma.

Updated 23 April 2015

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 good examples of joint working with midwives, health visitors, in particular to meet the needs of mothers in vulnerable circumstances, for example at higher risk of post-natal depression

Updated 23 April 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older patients, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 23 April 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 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. The practice’s performance for cervical smear uptake was 82.5%, which was above average for the CCG area and a low inadequate rate of 0.03%, compared to a national average of 2%.

Updated 23 April 2015

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 people experiencing poor mental health, including those with dementia. The practice worked with the community mental health team in the case management of people with severe mental health conditions. Out of 32 patients 24 had care plans reviewed and 12 out of 14 patients with dementia had care plans in place.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND. It 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.

Updated 23 April 2015

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 homeless people, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and 18 out of 21 of these patients had received a follow-up. It offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.