Archived: Cobridge Surgery

Updated 29 October 2015

Cobridge Surgery is situated in the Cobridge area of Stoke on Trent which is one of the most deprived areas in the country. The practice population is culturally diverse and transient. The practice is located within the Cobridge Health Centre which also accommodates a range of health care services and another GP practice. At the time of our inspection there were 4412 patients on the patient list.

The practice has two GP partners (although one was due to leave at the end of September 2015), a practice nurse, practice manager and reception and administration staff.

The practice is open from 8.30am until 6.30pm every day except Thursdays, when the practice closes at 1pm. Appointments were available from 8.50am to 11am and 2.30pm to 5pm. Patients could telephone the practice from 8am. Patients requiring a GP outside of normal working hours are advised to contact the practice and they will be directed to the out of hours service. This is provided by Staffordshire Doctors Urgent Care Limited. The practice has a GMS (General Medical Services) contract and also offers enhanced services for example: various immunisation schemes.

Updated 29 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cobridge Surgery on 2 September 2015. Overall the practice is rated as good.

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.

Our key findings were as follows:

• Staff knew how to and understood the need to raise concerns and report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and acted upon.
• Although the practice had not developed practice specific risk assessments, risks to patients had been assessed and were well managed.
• Best practice guidance was used to assess patients’ needs and plan and deliver their care. 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.
• Patient information, including how to complain was available and easy to understand.
• Patients told us they could usually get an appointment when they needed one, with urgent appointments available the same day. They also told us they may have to wait up to a week for a pre bookable appointment.
• The practice was located in a purpose build health centre with good facilities and suitable equipment to treat and meet patients’ needs.
• There was a clear leadership structure and staff felt supported by management.

We saw one area of outstanding practice:

• Stickers had been developed for children which incorporated a QR (quick response) code for smart phones. This took the user to the common childhood illnesses booklet on the practice website, which could be downloaded on the phone for future reference.

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

Importantly the provider must:

• Ensure that all necessary pre-employment checks are obtained and appropriate evidence kept on file.

The provider should:

• Consider having a designated lead for infection control and carry out infection control audits.
• Develop practice specific risk assessments.
• Review and update the disaster handling and recovery protocol.
• Consider recording informal / verbal complaints.
• Consider developing a strategic plan to support the delivery of the practice values and any future developments.
• Carry out risk assessment to ensure the safety of confidential information within the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 October 2015

The practice is rated as good for the care of people with long-term conditions. We found that the nursing staff had the knowledge, skills and competency to respond to the needs of patients with a long term condition such as diabetes and asthma. All of these patients were offered a review to check that their health and medication needs were being met. The practice had developed a range of information leaflets / action plans for patients with long term conditions. These included diabetic foot care, personal asthma action plan and winter care plan for chronic lung disease (which also included giving patients emergency medication). For those people with the most complex needs, the GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care.

Updated 29 October 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 who were at risk, for example, children and young people who had protection plans in place. The practice offered open access for children and same day emergency appointments were always available. There were screening and vaccination programmes in place and the immunisation rates although a number of the immunisation rates were below the local Clinical Commissioning Group average. We saw good examples of joint working with midwives and health visitors. The practice had developed s tickers for children which incorporated a QR (quick response) code for smart phones. This took the user to the common childhood illnesses booklet on the practice website, which could be downloaded on the phone for future reference. The practice had developed a range of information leaflet to assist parents of children who have viral wheeze.

Updated 29 October 2015

The practice is rated as good for the care of older people. Every patient over the age of 75 years had a named GP. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in end of life care and avoidance of unplanned admissions. It was responsive to the needs of older people and offered home visits and open access appointment for patients over the age of 65 years. The practice identified if patients were also carers and offered opportunistic health checks and advice.

Updated 29 October 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. A range of on-line services were available, including medication requests, booking appointments and access to health medical records. The practice does not offer extended hours but would see any patient who required an urgent appointment. The practice offered all patients aged 40 to 75 years old a health check with the practice nurse. The practice offered a full range of health promotion and screening that reflected the needs for this age group.

Updated 29 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice was a pilot site for handing out self-referral slips for the locally commissioned Healthy Minds service (a psychological service for common mental health problems). Patients also had access to a counsellor who visits the practice weekly. The practice worked closely with a local care home caring for people living with dementia, and had identified patients on antipsychotic medication and made referrals to psychiatric services for review. The practice also supported staff with capacity assessments and deprivation of liberty safeguards.

Updated 29 October 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice population was culturally diverse and we found that the practice enabled all patients to access their GP services. Staff made use of language line to support patients whose first language was not English. The practice held a register of patients with a learning disability and developed individual care plans for patients. The practice carried out annual health checks and offered longer appointments for patients with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. 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.