Dr Encarnacion Ruiz-Gutierrez

Updated 4 March 2020

Dr Encarnacion Ruiz-Gutierrez (also known as St. Luke’s Medical Centre) is a GP practice located in a residential area of Canning Town in the London Borough of Newham, East London. The practice provides NHS primary medical services through a General Medical Services (GMS) contract to approximately 5,800. It is one of two GP practices and a café situated within St Luke’s, a converted church which was built in 1875. Restoration of the building began in 1995, led by a charity formed by local people. The building is fully accessible, and parking is available on surrounding streets. The practice is well served by public transport links.

The clinical staff team are two lead GPs (one female and one male) collectively providing seventeen sessions weekly, one male regular locum GP providing one session, two regular part-time locum female practice nurse working three sessions, and a female healthcare working four full days per week. Non-clinical staff are a full time practice manager working and a team of reception and administrative staff working a variety of full and part time hours.

The practice has a website that contains information about what they do to support their patient population and the in house and online services offered:

Updated 4 March 2020

We carried out a focused inspection at Dr Encarnacion Ruiz-Gutierrez on 24 January 2020. The announced inspection was part of our inspection programme. Following a Care Quality Commission annual regulatory review to check for changes in quality we inspected the key questions effective and well-led. We used information from our previous inspection findings for the key questions safe, caring and responsive. The practice was previously inspected on 1 February 2018 and was rated good overall.

We based our judgement of the quality of care at this service on a combination of:

• What we found when we inspected,
• information from our ongoing monitoring of data about services
• and information from the provider, patients, the public and other organisations

We have rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We rated the practice as good for providing effective services and good for the population groups because:

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided.
• It ensured that care and treatment was delivered according to evidence-based guidelines.
• The practice understood the needs of its population and tailored services in response to those needs.

We rated the practice as good for providing a well led service because:

• There was a clear leadership structure and staff felt supported by management.
• The practice had a number of policies and procedures to govern activity and held regular governance meetings.
• The way the practice was led and managed promoted the delivery of person-centre care.
• The practice proactively sought feedback from staff and patients, which it acted on.

Whilst we found no breaches of regulations, the provider should:

• Continue to review and embed arrangements to ensure ongoing and sustainable improvement in clinical care indicators such as childhood immunisations and cervical screening.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 25 October 2016

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.

• Quality and Outcomes Framework (QOF) performance in 2014/15 for diabetes related indicators was 92% which was in line with the CCG average of 86% and the national average of 89%.

• A multi-disciplinary diabetes meeting was held every two months.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. 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.

• Targeted vaccination campaigns were held for flu with drop-in clinics held on Saturdays at the beginning of the season to maximise uptake.

Updated 25 October 2016

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.

• The practice’s uptake for the cervical screening programme was 80% which was comparable to the CCG average of 81% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Children under five years were prioritised for appointments.

• We saw positive examples of joint working with midwives, health visitors and school nurses. The health visitor attended the practice regularly to see patients.

Updated 25 October 2016

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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Older people were given priority for telephone consultations and home visits.

• Care plans for high risk patients were regularly reviewed.

Updated 25 October 2016

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.

• Early morning appointments (8am) were available depending on demand.

• Late evening and weekend appointments were available at one of a number of local GP hub sites.

• 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.

• Human papilloma virus (HPV) vaccine was provided and the practice participated in national immunisation campaigns for students.

Updated 25 October 2016

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

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 87% which was comparable to the CCG average of 84% and the national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• A severe mental illness liaison and consultant psychiatrist attended the practice regularly to see patients.

• The practice carried out advance care planning for patients with dementia.

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

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 25 October 2016

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.

• The practice offered longer appointments for patients with a learning disability, who received regular reviews.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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.

• Patients at risk of A&E attendance were identified and flagged and care plans were developed. They were also prioritised for appointments