Archived: Calder GP Community Practice

Updated 29 June 2016

Background to Calder Community Practice

Calder Community Practice is part of Locala Community Partnerships. It is located at Todmorden Health Centre, 82 Halifax Road OL14 5QN. The practice shares it’s purpose built accommodation with another GP practice. The practice is located on the second floor of the building, which is accessible by a lift. Calder Community Practice also hosts a walk in service which operates on weekends and bank holidays between 8am and 8pm.Calder Community Practice is joined with Park Community Practice, in Halifax. The practice list size is 5413 patients. Patients on this list can choose where they would like to be seen, although given the distance between the branches each practice tends to have it’s own list of patients. Calder Community Practice has a list size of approximately 2600 patients. These patients are predominantly white British. The practice provides Alternative Provider Medical Services (APMS) under a locally agreed contract with Calderdale CCG and NHS England.

There are four GPs, two of whom are male and two female. There are two female nurse practitioners, one locum male nurse practioner and two female health care assistants. At the time of our visit the practice were in the process of recruiting a practice nurse to complete the clinical team. Staff were shared across both sites. The team is supported by an operations lead, clinical lead, assistant practice manager and a range of administrative and reception staff. The practice team benefits from clinical, quality and governance support provided as part of the wider Locala organisation.

The practice is classed as being within one of the more deprived areas in England. People who live in more deprived areas tend to have greater need for health services.

Calder Community Practice is open between 8am and 6.30pm Monday, Tuesday, Thursday and Friday, and between 8am and 8pm on Wednesday. The practice is also open on Saturday morning between 8am and 1pm. A walk in service is also available on weekends and bank holidays 8am to 8pm.

Outside these hours out of hours cover is provided by Local Care Direct and is accessed via the surgery telephone number or by calling the NHS 111 service.

Updated 29 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Calder Community Practice on 3 May 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice was aligned with Park Community Practice, situated in Halifax. Patients were able to access services at either site. Park and Calder Community Practice was part of Locala, a social enterprise community interest company (CIC). All data relates to both practices collectively, unless specified otherwise.
• Locala had clear lines of accountability and governance which encompassed the whole organisation. Staff at the practice told us they felt supported by their immediate managers and by the organisation as a whole.
• The practice routinely sought feedback from staff and patients, and had a recently established patient participation group (PPG). We were given examples of how the practice had responded to patient comments and suggestions.
• We saw the practice had an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Clear guidance about how to complain was displayed in the practice and on the website.
• Patients said they found it easy to make an appointment with a GP or nurse practitioner. Urgent appointments were available the same day when required.
• The provider was aware of and complied with the requirements of the Duty of Candour.

There is an area where the practice needs to make improvements.

The provider should:

• Review the way carers are identified within the practice and develop systems to provide additional support to this group of patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 June 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.

• 94% of patients with diabetes, on the register had a recorded foot examination completed in the preceding 12 months compared to the CCG average of 89% and national average of 88%.

• 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.

• The practice had recently appointed a diabetic specialist nurse who was able to provide diabetic support up to level five. This meant that patients with diabetes on insulin or other injectables could have treatment initiated and managed in house by the practice. This included the management of diabetes in pregnant women, and patients who usedinsulin pumps to manage their condition.

Updated 29 June 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 accident and emergency (A&E) attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• 77% of patients with asthma, on the register had received an asthma review in the preceding 12 months compared to the CCG average of 76% and national average of 75%.

• Staff told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Appointments were available outside of school hours.

• Although the waiting area in the practice was small, we saw that baby changing facilities were available. Breast feeding mothers were offered a consulting room in which to feed their babies if they required one.

• Staff told us that they had regular meetings with health visitors and school nurses to discuss children and families with additional needs. At the time of our visit Park and Calder communitypractice had 10 children currently on a child safeguarding plan.

Updated 29 June 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.

• The practice made monthly telephone contact with the nursing homes for whom they had responsibility, to review the well-being of their residents, and help identify any unmet medical needs.

• The practice made use of Quest matrons. Quest matrons were a CCG wide initiative. They made routine visits to patients residing in nursing homes and provided a link between the nursing homes and the practice.

• Following the inspection we sought feedback from a nursing home who had residents registered with the practice.They told us they were happy with the service provided by the practice.

• The practice showed us data which indicated that 66% of eligible patients had completed an over 75 assessment in the previous year.

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Updated 29 June 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 acknowledged. The practice offered extended opening hours from 8am to 8pm on Wednesday, and on Saturday from 8am to 1pm.

• The practice offered online services as well as a full range of health promotion and screening that reflects the needs for this age group. Patients could be signposted to smoking cessation, weight management services which were delivered by local services.

• 76% of eligible women had had a cervical screening test performed in the preceding five years compared to the CCG average of 85% and the national average of 82%.

Updated 29 June 2016

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

• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is higher than the CCG and national averages of 84%.

• 100% of patients with schizophrenia or other psychoses had a comprehensive care plan completed in the preceding 12 months compared to CCG and national averages of 90% and 88% respectively.

• The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

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

• The practice gave patients experiencing poor mental health information how to access various support groups and voluntary organisations.

• Longer appointments of 20 minutes were routinely offered to patients experiencing poor mental health.

• 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 29 June 2016

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

• The practice was able to identify patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multidisciplinary teams in the case management of vulnerable people.

• 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.

• The practice had identified three vulnerable adults and 24 vulnerable families on their patient list. Eight people were registered as carers across both sites.