Rawmarsh Health Centre, Rawmarsh Customer Services Centre

Updated 1 December 2016

The practice, Rawmarsh Health Centre, Rawmarsh Customer Services Centre, provides services for 3,997 patents within the Rotherham CCG under a General Medical Services (GMS) contract.

The services are provided from a purpose built building which has car parking and easy access for wheelchairs and disabled toilet facilities.

The patient population is comparable to the national average and the practice is situated in one of the third most deprived areas nationally.

The practice was previously inspected on the 25 November 2013 and was found to be compliant in the areas we inspected.

There is one male GP supported by a salaried GP, a practice manager, practice nurse, health care assistant and reception team.

The practice is open Monday to Friday 8am to 6.30pm and extended hours are provided Tuesday and Thursday 7am to 8am. GP appointments are available Monday to Friday 8.30 am to 11am and 3.30pm to 5.30pm and Tuesday and Thursday 7am to 8am.

When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service.

The GP partners registered with the Care Quality Commission as the partnership did not reflect the GP partners at the practice. The Registered Manager had also changed. CQC had been notified of the changes and the GP told us application forms to amend this were in progress.

Updated 1 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive 21 September 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.
• Risks to patients were assessed and well managed. Although we saw areas which required improvement including, infection prevention and control training, temperature monitoring arrangements for vaccine fridges and access to keys to the storage area for blank prescriptions.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Provide infection prevention and control training for all clinical staff.
• Review arrangements in place for monitoring temperatures of fridges, provide two thermometers for vaccine fridges or calibrate the thermometer monthly.
• Review the arrangements to maintain security of blank prescriptions.
• Review the arrangements and processes for the allocation of administrative tasks. 

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 1 December 2016

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

• Nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.
• Data from 2014/15 showed the practice had achieved 100% in the majority of areas relating to long term conditions. However, we also saw that performance in three areas was below the CCG and national averages. For example:
• Performance for diabetes related indicators was 79%, 3% lower than the CCG average and 10 % lower than the national average.
• In asthma related indicators the practice achieved 92%, 5 % below the CCG and the national average.
• Indicators’ relating to the care provided to prevent fractures in patients with osteoporosis showed the practice performance was 86%, 7% below the CCG average and 15% below the national average.

The practice had had key members of staff, (GP, practice manager/long term conditions nurse) leave at the same time in 2015 which had impacted on the performance for 2014/15. The practice was aware of the data and had put action plans in place to improve these areas for 2016/17.

• 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 social care professionals to deliver a multidisciplinary package of care.

Updated 1 December 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 A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice’s uptake for the cervical screening programme was 90%, which was higher than the CCG average of 82% and the national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives and health visitors.

Updated 1 December 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 worked closely with social care agencies to ensure patients and their carers needs were met.

Updated 1 December 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 and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• The practice offered early morning appointments, 7am to 8am, on a Tuesday and Thursday morning for working patients who could not attend during normal opening hours. Telephone appointments were also available each day, with each GP, to allow opportunity for patients to speak with the GPs.

Updated 1 December 2016

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

• 94% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was 10% higher than the local and national average.
• Performance for mental health was 100%, which was 9% higher than the local average and 7% higher than the national average.
• Performance for Mental health was 100%, which was 9% higher than the local average and 7% higher than the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• 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. Staff and the patient participation group members had attended dementia friends training.

Updated 1 December 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 with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• Four appointments were made available every day specifically for those whose circumstances may make them vulnerable such as those living with dementia, those with a learning disability, carers or those under one year of age who may require same day appointments.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.