Archived: The Old Dairy Health Centre

Updated 19 February 2015

The surgery, which operates from a single location, is located in West Dulwich in the London borough of Lambeth and has a list size of just around 5,700 patients.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of: treatment of disease, disorder or injury; family planning; and maternity and midwifery services.

The practice has a Personal Medical Services (PMS) contract and provides a range of essential, additional and enhanced services including maternity services, child and adult immunisations, family planning clinic and contraception services. (Personal Medical Services agreements are locally agreed contracts between NHS England and a GP practice and offer local flexibility compared to the nationally negotiated General Medical Services (GMS) contracts).

The practice is currently open five days a week from 8:00am to 6:30pm. In addition, the practice offers extended opening hours from 6:30pm to 8:00pm every Monday and one Saturday every month from 9.00am to 12.00pm. The practice GPs do not provide an out-of-hours service to their own patients and patients are signposted to an out-of-hours service when the surgery is closed.

The surgery is currently situated in a converted and extended retail unit in a Victorian building on the high street. The surgery is not purpose built and its shortcomings include an outdated internal layout and limited waiting room area. We were shown the business plans that had been approved for re-location and the practice, we were told, would be moving to a new location in 2016.

The practice has a higher than average percentage of patients under 18 years of age and in the 30-49 year age groups.

The surgery clinical staff included three partners (one male and two female), two regular locum GPs, two nurses and one healthcare assistant. The practice also has a practice manager and an administration and reception team with six receptionist staff.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

The Rosendale Surgery, located in West Dulwich in the London borough of Lambeth provides a general practice service to around 5,700 patients.

We carried out an announced comprehensive inspection on 12 November 2014. The inspection took place over one day and was undertaken by a lead inspector, along with a GP advisor, a specialist advisor with a background in practice management and an Expert by Experience. We spoke with patients, members of the patient participation group (PPG), and staff including the management team.

Overall the practice is rated as Good.

Our key findings were as follows:

• The service is safe. There were systems in place for reporting, recording and monitoring significant events to help provide improved care. Staff were clear of their roles in regards to monitoring and reporting of incidents, safeguarding vulnerable people and children, and following infection prevention and control guidelines.

• The service is effective. Staff shared best practice through internal arrangements and meetings and also by sharing knowledge and expertise with external consultants and other GP practices. There was strong multidisciplinary input in the service delivery to improve patient outcomes.

• The practice is caring. Feedback from patients about their care and treatment via the national and practice-run surveys was very positive. Patients were treated with kindness and respect and felt involved in their care decisions. Almost all the comment cards completed by patients who used the service in the two weeks prior to our inspection visit had very positive comments about the care and service provided by the surgery.

• The practice is responsive to people’s needs. The practice had an active Patient Participation Group (PPG) and worked with them to improve the service. The practice was responsive to the needs of the vulnerable patients and there was a strong focus on caring and on the provision of patient-centred care. Information on health promotion and prevention, services provided by the practice and the support available in the community was available for patients.

• The practice is well-led. The practice had a clear vision and strategic direction, was well-led, staff were suitably supported and patient care and safety was a high priority.

We saw areas of outstanding practice in the joint working with the Patient Participation Group. Some instances included:

• Recognising the trend on complaints regarding appointment access, The practice discussed the various models of appointments systems they had researched with the PPG. The PPG then agreed with the practice the model they would pilot from April 2014.
• Joint working to gain approval for the business plans to relocate to a new purpose built surgery in 2016.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

Ensure the risk log is updated regularly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 February 2015

The practice is rated as good for the population group of people with long term conditions.

The clinical staff had the knowledge and skills to respond to the needs of patients with long term conditions such as cardiovascular diseases, diabetes mellitus, asthma and chronic obstructive pulmonary disease (COPD). Staff worked with other health professionals, such as for example, diabetes specialists to ensure a multi-disciplinary approach, and the care and medicines of patients in this group were reviewed regularly.

Updated 19 February 2015

The practice is rated as good for the population group of families, children and young people.

There were suitable safeguarding policies and procedures in place, and staff we spoke with were aware of how to report any concerns they had. Staff had received training on child protection which included Level 3 for GPs and nurses. There was evidence of joint working with other professionals to provide good antenatal and postnatal care. Baby immunisation clinics and mother and baby clinics with a nurse and GP were available and childhood immunisations were administered in line with national guidelines. Appointments were available outside of school hours and there was evidence of joint working with midwives, health visitors and school nurses.

Updated 19 February 2015

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

The practice was responsive to the needs of older people including those with dementia and offered a proactive, personalised care to meet their needs. Older people were cared for with dignity and respect and there was evidence of working with other health and social care providers to provide safe care. Support was available in terms of home visits and rapid access appointments for terminally ill and housebound patients.

Updated 19 February 2015

The practice is rated as good for the population group of the 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 there was a variety of appointment options available to patients such as telephone consultations, on-line booking and extended hours. The practice offered health checks, travel vaccinations and health promotion advice including on smoking cessation.

Updated 19 February 2015

The practice provided a caring and responsive service to people experiencing poor mental health.

The practice was signed up to the dementia enhanced service to provide care and support for people with dementia. The services were planned and co-ordinated to ensure that patient’s needs were suitably assessed and met. Reviews of care records of patients with dementia and mental health issues showed they were receiving adequate multi-disciplinary support and annual reviews of their health. Staff told us that they could also refer patients to access support from the community mental health teams.

Updated 19 February 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable.

People attending the practice were protected from the risk of abuse because reasonable steps had been taken to identify the possibility of abuse and prevent abuse from happening. The practice had policies in place relating to the safeguarding of vulnerable adults and whistleblowing and staff we spoke with were aware of their responsibilities in identifying and reporting concerns.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people and guided the patients to various support groups and third sector organisations. The practice was signed up to the learning disability enhanced service to provide an annual health check for people with a learning disability to improve their health outcomes. People with learning disabilities were offered longer appointments and the practice was on track to provide these checks within the financial year.