Hope Farm Medical Centre

Updated 31 March 2017

Hope Farm Medical Centre is responsible for providing primary care services to approximately 12,200 patients. The practice is based in an area with average levels of economic deprivation when compared to other practices nationally. The number of patients with a long standing health condition is about average when compared to other practices nationally.

The staff team includes five partner GPs, two salaried GPs, two advanced nurse practitioners, two practice nurses, two health care assistants, a practice manager and administration and reception staff.

The practice is open 8:00am to 6.30pm Monday to Friday. An extended hour’s service for routine appointments and an out of hour’s service are commissioned by West Cheshire CCG and provided by Cheshire and Wirral Partnership NHS Foundation Trust.

The practice has a General Medical Service (GMS) contract. The practice offers a range of enhanced services such as spirometry, anticoagulation therapy and minor surgery.

Updated 31 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Hope Farm Medical Centre on 4 May 2016. The overall rating for the practice was Good. The full comprehensive report on the May 2016 inspection can be found by selecting the ‘all reports’ link for Hope Farm Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 1 March 2017 to confirm that the practice had carried out the improvements that we identified as should be made in our previous inspection on 4 May 2016.

Overall the practice is rated as Good.

Our key findings were as follows:

The following improvements to the service had been made:

• The repeat prescribing protocol had been reviewed.

• The system for ensuring that learning was taken from significant events had been reviewed.

• A system had been introduced to record the receipt and allocation of printable prescriptions and to ensure all clinical equipment in GPs bags is regularly calibrated.

• A system had been put in place to ensure the regular replacement of all sharps boxes.

• The system in place for recording alerts to identify adults and children who are vulnerable and/or subject to safeguarding concerns, such as the deprivation of liberty safeguards (DoLS) had been reviewed.

The following improvement should be made:-

• The repeat prescribing protocol should include the action to be taken when a change is made to a patients repeat medication by another service such as the mental health team. The frequency of reviews of controlled drugs that are repeatedly prescribed and the checks GPs undertake prior to issuing and signing repeat prescriptions for controlled drugs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 August 2016

The practice is rated as good for the care of people with long-term conditions. The practice held information about the prevalence of specific long term conditions within its patient population such as diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation and osteoporosis. This information was reflected in the services provided, for example, reviews of conditions and treatment, screening programmes and vaccination programmes. The practice had a system in place to ensure patients attended regular reviews for long term conditions. The clinical staff took the lead for different long term conditions and kept up to date in their specialist areas. The practice had multi-disciplinary meetings to discuss the needs of palliative care patients and patients with complex needs. The practice worked with other agencies and health providers to provide support and access specialist help when needed. The practice referred patients who were over 18 and with long term health conditions to a well-being co-ordinator for support with social issues that were having a detrimental impact upon their lives. The practice won the 2015 West Cheshire Clinical Commissioning Group award (WCCCG) for supporting patients with long term conditions. This was based on results from a patient survey by WCCCG that indicated the practice performed better than other practices in the area. As a result of this the practice had been selected to introduce new models of care for patients with long term conditions. The practice was also part of a project that offered patient peer coaching. Patients could be referred to this service where support was provided by patients who had undertaken training to enable them to support other patients with similar conditions.

Updated 5 August 2016

The practice is rated as good for the care of families, children and young people. Maternity, family planning, child health surveillance and immunisation services were provided. The practice targeted specific population groups and proactively promoted immunisation to encourage uptake. Childhood immunisation rates for vaccinations given for the period of April 2014 to March 2015 were comparable to the CCG averages (where this comparative data was available). The staff we spoke with had appropriate knowledge about child protection and they had access to policies and procedures for safeguarding children. Staff had safeguarding training relevant to their role. GPs provided reports for child safeguarding meetings to ensure the practice was up to date with any concerns and any relevant information could be shared.

Updated 5 August 2016

The practice is rated as good for the care of older people. The practice was knowledgeable about the number and health needs of older patients using the service. They kept up to date registers of patients’ health conditions and used this information to plan reviews of health care and to offer services such as vaccinations for flu and shingles. The practice had identified patients at risk of unplanned hospital admission and a care plan had been developed to support them. The practice worked with other agencies and health providers to provide support and access specialist help when needed. Multi-disciplinary meetings were held to discuss and plan for the care of frail and elderly patients. The practice was working with neighbourhood practices and the CCG to provide services to meet the needs of older people. For example, they had worked with neighbourhood practices to develop and deliver an advanced nurse prescriber led service that provided joint nursing visits to housebound patients and co-ordination of the Integrated Care Team, making processes within this team more joined up and efficient. The practice provided services to four nursing homes and daily visits were conducted by the advanced nurse practitioners with support from the GPs. Additional GP contact was available as required by the nursing homes. The practice had recently organised an event for Pets as Therapy to visit nursing home patients.

Updated 5 August 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice offered pre-bookable appointments, book on the day appointments and telephone consultations. Patients could book appointments on-line or via the telephone and repeat prescriptions could be ordered on-line which provided flexibility to working patients and those in full time education. The practice was open from 8:00am to 6:30pm Monday to Friday allowing early morning and late evening appointments to be offered to this group of patients. An extended hour’s service for routine appointments was commissioned by West Cheshire CCG. The practice website provided information around self-care and local services available for patients. The practice promoted services for this group of patients, for example, the meningitis c vaccination for university students. Blood tests were provided at the practice every morning which provided convenience for working patients.

Updated 5 August 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). GPs worked with specialist services to review care and to ensure patients received the support they needed. The practice maintained a register of patients who experienced poor mental health. The register supported clinical staff to offer patients experiencing poor mental health, including dementia, an annual health check and a medication review. The practice referred patients to appropriate services such as psychiatry and counselling services. The practice had information in the waiting areas about services available for patients with poor mental health. For example, services for patients who may experience depression. Clinical and non-clinical staff had undertaken training in dementia to ensure all were able to appropriately support patients. The practice had worked with the Patient Participation Group to provide an educational talk to any patients impacted by dementia or who wanted to learn more.

Updated 5 August 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Patients’ electronic records contained alerts for staff regarding patients requiring additional assistance. For example, if a patient had a learning disability to enable appropriate support to be provided. There was a recall system to ensure patients with a learning disability received an annual health check. The staff we spoke with had appropriate knowledge about safeguarding vulnerable adults and all staff had safeguarding training relevant to their role. Se rvices for carers were publicised and a record was kept of carers to ensure they had access to appropriate services. A member of staff was the carer’s link. A representative from the Carers Trust visited the practice and provided information for patients about the services provided. The practice referred patients to local health and social care services for support, such as drug and alcohol and domestic violence services. The practice also referred patients who were over 18 and with long term health conditions to a well-being co-ordinator for support with social issues that were having a detrimental impact upon their lives.