Background to this inspection
Updated
6 February 2018
The Somerset Gardens Family Health Care Centre is located in Tottenham, London Borough of Haringey, North London. The practice has a patient list of approximately 13,000 patients. Twenty six percent of patients are aged under 18 (compared to the national practice average of 21%) and 10% are 65 or older (compared to the national practice average of 17%). Sixty percent of patients have a long-standing health condition and practice records showed that 1% of its practice list had been identified as carers.
The services provided by the practice include child health care, ante and post natal care, immunisations, sexual health and contraception advice and management of long term conditions.
The practice holds a Personal Medical Services contract with NHS England. This is a locally agreed alternative to the standard General Medical Services contract and includes additional services beyond the standard contract.
There are currently four partner GPs and two salaried GPs (3 female and 1male), two part time female nurses, a partner practice manager and a team of reception/administrative staff.
The practice’s opening hours are:
The practice offers extended hours opening at the following times:
The practice is also part of a local HUB network enabling patients to be seen (at the practice):
Outside of the above times, cover is provided by an out of hours provider.
The practice is registered to provide the following regulated activities which we inspected:
Maternity and midwifery services; Diagnostic and screening procedures; Surgical procedures; Family planning; Treatment of disease, disorder or injury
Updated
6 February 2018
Letter from the Chief Inspector of General Practice
This practice is rated as Good overall. (Previous inspection 7 January 2015- Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Good
Families, children and young people – Good
Working age people (including those recently retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Good
We carried out an announced inspection at Somerset Gardens Family Health Care Centre
on 23 November 2017 as part of our inspection programme.
At this inspection we found:
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The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice improved their processes (although we noted that learning was not always shared with relevant staff members).
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Results from the national GP patient survey showed that patients’ satisfaction with how they could access care and treatment were below local and national averages. However, we saw evidence of actions taken to improve how people could access appointments and services in a way and at a time that suited them.
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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.
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All staff were actively engaged in activities to monitor and improve quality and outcomes.
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Staff involved and treated patients with compassion, kindness, dignity and respect.
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There was a strong focus on continuous learning and improvement at all levels of the organisation.
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We saw examples of inclusive leadership.
The areas where the provider should make improvements are:
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Review how learning from significant events is shared amongst staff.
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Monitor recently introduced initiatives aimed at improving patient satisfaction on appointments access.
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Continue to monitor and improve child immunisation uptake (5 year olds).
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Ensure that appropriate arrangements are in place to monitor the risk from Legionella (a term for a particular bacterium which can contaminate water systems in buildings).
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
People with long term conditions
Updated
30 April 2015
The practice is rated as good for the population group of people with long term conditions. Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health. When needed longer appointments and home visits were available. All these patients had a named GP and structured annual reviews to check their health and medication needs were being met. For those people with the most complex needs the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
Families, children and young people
Updated
30 April 2015
The practice is rated as good for the population group of families, children and young people. Systems were in place for identifying and following-up children living in disadvantaged circumstances and who were at risk, such as those, who had a high number of A&E attendances. Patients told us and we saw evidence that children and young people were treated in an age appropriate way and recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. There were baby change facilities, space for prams and buggies and a play area. We were provided with good examples of joint working with midwives, health visitors and school nurses. Emergency processes were in place and urgent referrals made for children and pregnant women who had a sudden deterioration in health.
Updated
30 April 2015
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 and had a range of enhanced services, for example in dementia and end of life care. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs and home visits.
Working age people (including those recently retired and students)
Updated
30 April 2015
The practice is rated as good for the population group of the 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 offer continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening which reflects the needs for this age group.
People experiencing poor mental health (including people with dementia)
Updated
30 April 2015
The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). All patients on the practice list identified as having poor mental health had received an annual physical health check in the 2013/2014 time period. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. The practice had advance care planning in place for patients with dementia.
The practice had signposted patients experiencing poor mental health to various support groups and third sector organisations including MIND and SANE. The practice had a system in place to follow up on patients who had attended accident and emergency for urgent care and where there may have been underlying mental health needs. Staff had received training on how to care for people with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
30 April 2015
The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector 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 and out of hours. All patients on the practice list identified as having learning difficulties had received an annual health check in the 2013/14 time period.