Archived: Lavender Centre

Updated 27 September 2018

Gardiner Crescent Surgery provides care and treatment to around 2,100 patients in Chester le Street, County Durham. The practice is part of North Durham clinical commissioning group (CCG) and operates on a Personal Medical Services (PMS) contract agreement for general practice.

The provider was formerly a group practice but changed in November 2017 to a sole provider, Dr Richard Hall. The new provider also has another surgery and provides services from the following two addresses, which we visited during this inspection:

• Gardiner Crescent Surgery, 21 Gardiner Crescent, Pelton Fell, Chester le Street, County Durham, DH2 2NJ
• Lavender Centre, Unit 1, The Lavender Centre, Pelton Lane, Pelton, Chester le Street, County Durham, DH2 1HS

The Gardiner Crescent surgery is located in a converted two storey building. Patient facilities are on the ground floor. There is on street parking, an accessible WC, wheelchair and step-free access.

The Lavender Centre surgery is located in a purpose built two storey building. Patient facilities are on the first floor. There is a designated car park, accessible parking, an accessible WC, a lift to the first floor, wheelchair and step-free access.

Patients can book appointments in person, on-line or by telephone and could attend either site.

The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and County Durham and Darlington NHS Foundation Trust.

The practice has:

• One GP partner (male),
• one salaried GP (female),
• two practice nurses (female),
• a healthcare assistant,
• a business manager,
• a deputy practice manager, and
• five staff who carry out reception and administrative duties.

The age profile of the practice population is broadly in line with the local and national averages; the proportion of patients over the age of 65 was above average (19% compared to the national average of 17%) and there is a lower than average proportion of patients under the age of 18 (18% compared to the national average of 21%). Information taken from Public Health England placed the area in which the practice is located in the fourth more deprived decile. In general, people living in more deprived areas tend to have greater need for health services.

Updated 27 September 2018

This practice is rated as Requires Improvement overall. (Previous rating under former provider 01 2017 – Good)

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at Gardiner Crescent Surgery on 22 and 23 August 2018 as part of our inspection programme.

At this inspection we found:

• Staff demonstrated a very caring approach to their patients and it was clear they treated them with compassion, kindness, dignity and respect.
• The practice scored well in the National GP Patient Survey across all areas.
• Clinicians assessed patients’ needs and delivered person-focussed care and treatment.
• The practice had some systems in place to manage risk, so that safety incidents were less likely to happen. When incidents did happen, the practice improved processes to keep patients safe. However, the practice’s arrangements for responding to safety alerts was not sufficient. There were some gaps in the practice’s arrangements for identifying, assessing and managing risk.
• Staff demonstrated they were committed to making improvements and there was some evidence of this in the quality improvement activity they undertook. . However, there was no programme of continuous clinical audit to monitor quality.
• There were gaps in some staff’s training.
• Appropriate recruitment checks had not been carried out for some staff who worked at the practice.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was some evidence the practice engaged with their patients. However, this was limited and the practice did not have an active patient participation group.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance, in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal to enable them to carry out their duties.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

The areas where the provider should make improvements are:

• Review the process for prescribing antibiotics to conform with best practice.
• Consider increasing the support provided to carers.
• Review arrangements for offering the meningitis vaccine to students.
• Continue to take steps to encourage uptake of annual checks for patients with learning disabilities.
• Review and improve patient engagement.
• Reduce those exception reporting rates which are higher than the local clinical commissioning group and England averages.
• Continue to provide support to ensure the practice management team have the relevant skills to fulfil their roles.
• Take steps to ensure the practice obtains assurance that the defibrillator is regularly serviced and checked to ensure it is in full working order.
• Carry out a risk assessment to determine which emergency drugs are suitable to store at the practice.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Updated 27 September 2018

Updated 27 September 2018

Updated 27 September 2018

Updated 27 September 2018

Updated 27 September 2018

Updated 27 September 2018