Red Roofs Practitioners

Updated 25 February 2016

Red Roofs Surgery is located in Nuneaton, north Warwickshire, on the edge of the town centre. The practice is run as a partnership and was first established in 1896. It moved to its current building in the same road in the 1980s. The practice provides primary medical services to patients in an urban and semi-rural area. Locally there are some areas of deprivation.

At the time of our inspection there were 15,300 patients registered with the practice. This included patients in eight local care homes, some with dementia. The practice also serves the local bail hostel.

A building refurbishment has been started and this includes the approval of plans to extend the practice into rooms that were formerly sub-let for commercial use. This would allow to the practice to meet an increased patient demand, provide a new patient waiting area and also consider the introduction of additional services for patients. This is due to be completed by the end of March 2016.

The practice 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 has five partner GPs and five salaried GPs, a mix of male and female. There are also three practice nurses and a healthcare assistant based at the practice. They are supported by a practice manager and administrative and reception staff. Red Roofs Surgery is an approved training practice for doctors who wish to be become GPs. A GP trainee is a qualified doctor who is training to become a GP through a period of working and training in a practice. Only approved training practices can employ GP trainees and the practice must have at least one approved GP trainer.

The practice is open from 8am to 12pm and from 1.30pm to 6.30pm during the week. Appointments are available throughout those times. Extending hours opening is available on Saturdays from 8am to 12pm with one GP and one practice nurse on duty. When the practice is closed, patients can access out of hours care 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.

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. Appointments are available for maternity care, family planning and smoking cessation.

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Red Roofs Surgery on 24 November 2015. Overall the practice is rated as good for providing safe, effective, caring, responsive and well led services.

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

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. The practice worked closely with other local practices and acute providers such as Nuneaton’s George Eliot hospital.

• Patients said they found it easy to make an appointment with a named GP, that there was continuity of care, and urgent appointments were usually available the same day.

• Staff had received training appropriate to their roles and any further training needs had been identified and planned. Staff training was also linked to the staff appraisal scheme to ensure staff were fully developed to best meet the needs of patients.

• Risks to patients were assessed and well managed with appropriate systems in place.

• The practice had good facilities and was well equipped to treat patients and meet their needs. A building refurbishment was taking place.

• There was a clearly defined leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 25 February 2016

The practice is rated as good for the care of people with long-term conditions. The practice used a chronic disease management system to monitor patients with chronic diseases. Management of patients with long term conditions was carried out by the practice nursing team and healthcare assistant. Patients at risk of hospital admission were closely monitored. Longer appointments and home visits were available when needed. Patients were reviewed at least annually, sometimes more frequently depending on the condition they had and its severity. All patients diagnosed with a long term condition had a structured annual review to check that their health and medicine needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice also offered dietary, weight management and smoking cessation advice. All members of practice staff and the Patient Participation Group (PPG) had received dementia friends training to enable them to provide a higher level of support to patients with dementia.

Updated 25 February 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 of abuse. For example, children and young people who had a high number of accident and emergency (A&E) attendances.

The practice ran baby clinics and post-natal appointments. The practice had a policy providing same day appointments for children and appointments were also available outside of school hours. The premises were suitable and accessible for children, with changing facilities for babies. We saw good examples of joint working with midwives, health visitors, school nurses and district nurses. The practice notified Child Health Services when babies and children did not attend for their vaccinations.

The practice also offered a number of online services including booking appointments and requesting repeat medicines.

Updated 25 February 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. It was responsive to the needs of older people, and offered home visits for those unable to reach the practice. A weekly ‘ward round’ was carried out in the eight care homes the practice had patients living in. The practice had also worked closely with these care homes to ensure procedures covered by the Mental Capacity Act were correctly followed.

At the time of our inspection, the practice was delivering its 2015-2016 flu vaccination programme. The practice worked closely with the local risk stratification enhanced service to closely monitor patients most at risk. This included those most at risk of unplanned hospital admission. The practice staff held weekly meetings to review hospital admissions and accident and emergency attendances and had developed a computerised tracker to record outcomes and identify trends.

Updated 25 February 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. Telephone consultations were available for patients who were unable to reach the practice during the day. Extended hours opening was available on Saturday mornings for patients who worked during the week. The practice was proactive in offering online services as well as a full range of health promotion and screening services that reflected the needs for this age group.

Updated 25 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams to plan care and treatment with patients who experienced poor mental health, including those with dementia. It carried out advanced care planning and annual health checks for patients with dementia and poor mental health. The clinical team understood the importance of considering patients’ ability to consent to care and treatment and dealt with this in accordance with the requirements of the Mental Capacity Act 2005.

The practice had advised patients experiencing poor mental health how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E). Staff had received training on how to care for people with mental health needs and dementia.

Updated 25 February 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 those patients with a learning disability. For example, the practice had carried out annual health checks and offered longer appointments for patients with a learning disability. Members of the traveller and gypsy communities were also able to register at the practice.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had advised vulnerable patients on how to access various support groups and voluntary organisations. Alerts were placed on these patients’ records so that staff were aware they might need to be prioritised for appointments and offered additional attention such as longer appointments. The practice staff held weekly meetings to review hospital admissions and accident and emergency attendances and had developed a computerised tracker to record outcomes and identify trends.

Staff had received training and knew how to recognise signs of abuse in adults whose circumstances made them vulnerable and children who were considered to be at risk of harm. 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.

A GP partner had training and experience with working with a drug and alcohol service and a scheme for violent and aggressive patients. As a result, the practice was able to meet the needs of patients within these categories and provide additional support when needed.