Archived: Parkstone Tower Practice Also known as Dr Primavesi & Partners

Updated 14 February 2017

Parkstone Health Centre is a training practice situated in Poole, Dorset. The practice has been at its present location since 1973. It is based on the first floor of a building it shares with Dorset Healthcare (an NHS community health service) and a pharmacy.

The practice is part of a GP federation formed in November 2014 and comprises of eight local GP practices that collaborate in the development of local primary care services.

The practice has an NHS personal medical services contract to provide health services to approximately 10,250 patients.

Parkstone Health Centre is located in the south of Poole. The mix of patient’s gender (male/female) is almost half and half. The practice has a higher number of patients aged between 25 and 34 years old and female patients over 80 years old when compared to the England average.

The practice is open from 8am to 6.30pm from Monday to Friday. Appointments are available during these times. Additional appointments are available on Wednesday evening between 6.30pm and 8pm and Thursday morning between 7.30am and 8am.

The practice has opted out of providing out-of-hours services to their own patients and refers them to South Western Ambulance Trust via the NHS 111 service. Information on how to access these services is publicised on th practices website on on the patient information leaflet.

Staff working at the practice includes four GP partners, two salaried GPs and two GP registrars (doctors training to be GPs) who together work an equivalent of 6.2 full time staff.

In total there are four male and four female GPs. The practice employs a nurse prescriber, three practice nurses and a health care assistant. The GPs and the nursing staff are supported by a team of 12 administration staff who carry out administration, reception, document scanning and secretarial duties. The practice also has a reception manager and a practice manager.

We carried out our inspection at the practice’s only location:

Mansfield Road

Parkstone

Poole

Dorset

BH14 0DJ.

Updated 14 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkstone Health Centre on 16 September 2015. Overall the practice is rated as good. The practice was rated good for providing caring, effective, responsive and well-led services. However, we found breaches of Regulation 12 (safe care and treatment) and Regulation 19 (fit and proper persons employed) of The Health and Social Care Act (Regulated Activities) Regulations 2014. The practice was rated as requires improvement for providing safe services.

We issued two requirement notices and informed the practice that they must make the following improvements:

• Ensure blank prescriptions are logged and tracked throughout the practice.

• Ensure vaccines are stored in a safe and secure way.

• Ensure patient group directions are authorised appropriately.

• Ensure recruitment arrangements include all necessary employment checks for all staff.

We carried out a focused follow inspection on 28 November 2016 to assess if the practice had implemented the changes needed to provide safe services. During this focussed inspection we found the provider had taken appropriate action to meet the requirements and following a review of evidence the practice is now rated as good for providing safe services, with the practice now being rated as good for all domains and population groups.

This report covers our findings in relation to the requirements and should be read in conjunction with the report published in December 2015. This can be done by selecting the 'all reports' link for Parkstone Health Centre on our website at www.cqc.org.uk.

Our key findings across all the areas which we inspected on 28 November 2016 were as follows:

• The practice had implemented a system to ensure all prescriptions were managed and tracked in accordance to current guidelines.

• Vaccines were now stored safely and securely.

• Patient group directions had been authorised appropriately.

• The practice had in place evidence of all relevant, required employment checks for all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 December 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.
• Longer appointments and home visits were available when needed.
• Patients who had been identified as having a long term condition had a named GP and a structured annual review to check that their health and medicines needs were being met. Reviews of patients with more than one chronic condition were carried out at a single appointment, which reduced unnecessary appointments and followed latest guidelines.
• 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.
• A number of specialist meetings took place with individual named GPs for defined long term conditions, for example palliative care and asthma.

Updated 24 December 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 on children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency attendances.
• Immunisation rates were above the national average for all standard childhood immunisations.
• 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.
• Health promotion advice was offered and there was health promotion material available through the practice.
• Health Visitors were based in the practice which supported communication both on a face to face level and at multi-disciplinary meetings.

Updated 24 December 2015

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.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The percentage of people aged 65 or over who received a seasonal flu vaccination was in line with clinical commissioning group and national averages.
• All patients over 75 were informed of their named GP and consented to that GP offering them continuation of care.
• A 20 minute annual health check was offered by Parkstone Health Centre and carried out either at the practice or in the patient’s home.

Updated 24 December 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 that it was accessible, flexible and offered continuity of care to this group.
• The practice offered extended hours with GPs and nurse appointments available on Wednesday evenings and Thursday mornings to enable patients to attend either before or after work.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 24 December 2015

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• It had a system in place to follow up patients who attended accident and emergency where they may have been experiencing poor mental health.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• It carried out advance care planning for patients with dementia and 84.6% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• Staff had received training on how to care for people with mental health needs and dementia.

Updated 24 December 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.
• Every year patients who had a learning disability were invited to a review of their care and treatment. The practice also offered longer appointments for this population group.
• Patients who were identified as vulnerable had their records highlighted so that staff were aware of their needs and attention.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• It 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.