Manor Court Surgery

Updated 21 September 2016

Manor Court Surgery is located in Nuneaton, close to the town centre. It is an urban area with a significant number of patients from various ethnic minorities. This includes a large Nepalese (Gurkha) community as many former service personnel and their families have made Nuneaton their home.

The practice is run as a partnership and has 9350 patients registered. It is housed in part of Nuneaton’s former Victorian hospital building which has been fully refurbished and converted into a purpose made GP practice. It has a General Medical Services (GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice is part of a local GP federation. A group of practices who work together to share best practice and maximize opportunities to improve patient outcomes.

The practice has four partner GPs (all male) and a female locum GP who has regular sessions there and a physician’s associate who is specially trained to support clinical staff in their duties. There are also two practice nurses and healthcare assistants. They are supported by a practice manager and administrative and reception staff.

The practice has four partner GPs (three male and one female) and a physician’s associate (female) who is specially trained to support clinical staff in their duties. There are also two practice nurses and healthcare assistants. They are supported by a practice manager and administrative and reception staff.

The practice is open from 8.00am to 6.30pm during the week. Appointments are available throughout these times. An open surgery is held every Monday from 9 am to 10.20am when every patient who arrives will be seen by a GP. Extended hours appointments are available on Mondays and Tuesdays from 6.30pm to 7pm (both days are for telephone consultations), Wednesdays from 7am to 8am and on one Saturday each month from 8am to 10.30am. Appointments are also available with the practice nurse on three mornings each week from 7.30am to 8am.

When the practice is closed, patients can access out of hours care provided by Care UK through NHS 111. The practice has a recorded message on its telephone system to advise patients. This information is also available on the practice’s website and in the patient practice leaflet.

Home visits are available for patients who are unable to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions and book new appointments without having to telephone the practice. Telephone appointments are available for patients who are unable to reach the practice during normal working hours.

The practice treats patients of all ages and provides a range of medical services. This includes minor surgery and disease management such as asthma, diabetes and heart disease. Other appointments are available for blood tests, family planning and smoking cessation. The practice also cares for patients who live in some of the local nursing homes.

Updated 21 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Manor Court Surgery on 9 August 2016. Overall the practice is rated as good.

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

• Patients’ needs were assessed and care delivered in line with current guidelines. Staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Urgent same day patient appointments were available when needed. Most patients we spoke with and those who completed comment cards before our inspection said they were always able to obtain same day appointments. Three patients said they had difficulty obtaining appointments, but there were appointments available on the day of our inspection.
• The practice team engaged with the local community and organised events and initiatives to reach patients who were potentially more vulnerable and harder to reach and also the local ethnic minority groups.
• Patients said they were treated with dignity, respect and compassion. Patients were involved decisions about their care and treatment.
• Information about how to complain was available and easy to understand. The practice received very few complaints from patients and reviewed complaints to ensure lessons were learned.
• Patients said GPs gave them enough time.
• Risks to patients were assessed and well managed.
• There were clearly defined processes and procedures to ensure patients were safe and an effective system in place for reporting and recording significant events. They were fully reviewed at every staff meeting.

We saw the following areas of outstanding practice:

• The practice team engaged with the local community and organised events and initiatives to reach patients who were potentially more vulnerable and harder to reach, this included local ethnic minority groups. The practice ran health promotion events and provided NHS health checks at the local mosque and also at events for the local Nepalese (Gurkha) community. Meetings with key community leaders were held to discuss health needs and developments. NHS health checks had also been carried out at the local food bank and the practice.

The area where the provider should make improvement is:

• Continue to closely monitor patient survey results and patient comments about availability of appointments to identify where further improvements could be made.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 21 September 2016

The practice is rated as outstanding for the care of people with long-term conditions.

• The practice had a register of patients with long term conditions to enable their health to be effectively monitored and managed.

• Patients had a named GP and a review every six to 12 months to monitor their condition and ensure they received correct medicines. The frequency of the review depended on the severity of the patient’s condition.

• All patients with a long term condition were invited for an annual review in the month of their birth. The practice found this simplified the call/recall system as patients were more aware of when their review was due. Attendance had increased as a result.

• Nursing staff had received appropriate training in chronic disease management, for example asthma and diabetes.

• The practice achieved a 93% flu vaccination record for diabetes patients during 2015-2016. This was slightly below the Clinical Commissioning Group (CCG) average of 96% and the national average of 94%.

• Longer appointments and home visits were available when needed.

Updated 21 September 2016

The practice is rated as good for the care of families, children and young people.

• Systems were in place to identify children and young people who might be at risk, for example, those who had a high number of A&E attendances.

• A total of 85% of eligible patients had received cervical screening in the last 12 months. This was above the Clinical Commissioning Group (CCG) average of 83% and the national average of 81%.

• There were appointments outside of school hours and the practice building was suitable for children and babies.

• Outcomes for areas such as child vaccinations were in line with or above average for the CCG.

• We saw positive examples of joint working with midwives and the local health visitor. Midwife appointments were available twice-weekly at the practice and practice staff met with the health visitor every month.

• A full range of family planning services were available.

• The practice worked with and referred patients to an under 19’s service called ‘PIPPS’ (Providing Information and Positive Parenting Support). This is an initiative that worked with pregnant teenagers and provided support across healthcare boundaries as well as working with partner agencies such as children’s centres and health visitors to ensure the physical and emotional needs of young mums were met.

Updated 21 September 2016

The practice is rated as good for the care of older people.

• Older patients were given personalised care which reflected their needs.

• Care plans were in place with the most vulnerable older patients and used with multi-disciplinary teams to reduce unplanned hospital admissions. These patients had an alert placed on their patient records to ensure clinical staff were aware. Patients discharged from hospital were contacted within 48 hours to ensure everything was in place and they were safe and well.

• Over the last 12 months all patients aged 75 and over had been invited for a health check. This included blood tests, fracture assessment, frailty assessment, and checks for depression and dementia. From those checks, the practice identified patients who needed further investigation and referred them appropriately.
• The practice worked with an Age Co-ordinator employed by Age Concern. This was a pilot scheme with the CCG, to ensure elderly patients received appropriate care and support.
• The practice provided frailty checks.

• Home visits were offered to patients who could not reach the practice.

• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

Updated 21 September 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice ensured it provided services to meet the needs of the working age population, For example, extended hours appointments were available during the week and on monthly Saturday mornings.

• During the flu vaccination season, Saturday morning appointments were available.

• Telephone consultations were available for patients who were unable to reach the practice during the day.

• The practice held a walk in service from 9am to 10.20am on Mondays and any patient who walked in would be seen.

• A full range of services appropriate to this age group was offered, including travel vaccinations.

Updated 21 September 2016

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

• The practice had a register of patients with poor mental health to enable their health to be effectively monitored and managed.

• The practice worked with multi-disciplinary teams to provide appropriate care for patients with poor mental health. This included patients with dementia.

• Patients who were diagnosed with depression received a follow up from a GP within eight weeks of diagnosis.

• Patients were signposted to appropriate local and national support groups.

• Staff demonstrated a good working knowledge of how to support patients with mental health needs and dementia.

Updated 21 September 2016

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

• The practice had a register of patients who were vulnerable to enable their health to be effectively monitored and managed. This included patients with a learning disability.

• The practice supported vulnerable patients to access various support groups and voluntary organisations.

• Longer appointments were available for patients with a learning disability.

• The practice worked with other health care professionals to provide care to vulnerable patients, for example, the district nursing team.

• Staff could recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities to share appropriate information, record safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

• Staff could recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities to share appropriate information, record safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

• The practice provided items such as sleeping bags and warm clothing for homeless people.