What is the Quality of Facilities at Albion Medical Practice

Positive

"• Staff encouraged and supported patients to be involved in monitoring and managing their health."

Positive

"However the practice had identified the need to improve monitoring and share learning and had diried in quarterly meetings to look specifically at significant events in addition to the monthly clinical meetings."

Positive

"However we found that the practice did not have a formal system in place for monitoring vulnerable adults and although there was a child safeguarding register and safeguarding concerns were discussed at partner meetings and as part of multidisciplinary meetings this was not formally reviewedmonitored by the safeguarding lead."

Positive

"However we found that the system for monitoring action taken in light of significant events were not always reviewed and documented."

Positive

"• There was an effective process to identify understand monitor and address current and future risks however systems to monitor risks to patient safety needed to be more robust for example MHRA alerts and monitoring safeguarding."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Neutral

"• Formalise the system for monitoring uncollected prescriptions."

Neutral

"• There were arrangements for planning and monitoring the number and mix of staff needed."

Positive

"Management monitoring and improving outcomes for people Staff across the practice had key roles in monitoring and improving outcomes for patients."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Neutral

"Staff told us about the arrangements for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs."

Positive

"The practice undertook quality monitoring audits such as environmental and maintenance checks to ensure that the service provided was satisfactory and effective."

Positive

"Management monitoring and improving outcomes for people The practice manager and other staff we spoke to were able to evidence that clinical audits were undertaken in order to improve outcomes for people."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Positive

"• Practice leaders had established proper policies procedures and activities to ensure safety and assured themselves that they were operating as intended."

Positive

"• The practice valued training and staff development both of internal staff but also mentoring and supporting trainee GPs and training staff to become health care assistants and supported nurse to become advanced practitioners."

Positive

"The team consisted of a GP nurse and a medicines management technician and who were the first point of contact for patients and their relatives and care homes."

Positive

"The GP and practice nurse also accommodated home visits for those who had difficulties getting to the practice due to limited local public transport availability."

Positive

"• Emergency on the day appointments were available daily with either an advanced nurse practitioner or GP."

Neutral

"• Patients requiring urgent appointments were able to be seen on the day by either an advanced nurse practitioner or GP."

Positive

"A GP community liaison nurse and the services of a pharmacy technician had been secured."

Positive

"A GP community liaison nurse and the services of a pharmacy technician have been secured."

Positive

"There is also a vacancy for an advanced nurse practitioner."

Neutral

"The team included a GP specialist advisor and a nurse specialist adviser as well as an expert by experience."

Neutral

"Wheelchair access is available to the nurse consulting rooms through a back lower level entrance."

Neutral

"Wheelchair access was available to the nurse consulting rooms through a back lower level entrance."

Positive

"The assistant nurse practitioner was the infection control lead and was aware of requirements such as sharps disposal and what to do in the event of a needle stick injury."

Positive

"If a mother was unable to attend a specific vaccination session then an appointment could be made outside of these times with a practice nurse who would carry out the procedure for them."

Positive

"There were five GP partners and a GP trainee as well as an advanced nurse practitioner practice nurses and an assistant practitioner who were all able to provide a service."

Positive

"Clinical supervision meetings were carried out regularly between the advanced nurse practitioner and junior doctors and their supervising mentors."

Positive

"The practice staff described a recent emergency when a receptionist had been concerned about a patient and emergency action had been required."

Neutral

"Patients we spoke with were aware of the process to follow and most said they would speak to the practice manager or a receptionist if they had any concerns."

Positive

"The GP and practice nurse also accommodated home visits for those who had difficulties getting to the practice due to limited local public transport availability."

Neutral

"“Cold chain” refers to the process used to maintain optimal conditions during the transport storage and handling of vaccines starting at the manufacturer and ending with the administration of the vaccine to the client."

Positive

"The GP and practice nurse also accommodated home visits for those who had difficulties getting to the practice due to limited local public transport availability."

Neutral

"• The practice ensured that end of life care was delivered in a coordinated way which took into account the needs of different patients including those who may be vulnerable because of their circumstances."

Neutral

"The practice held multidisciplinary team meetings on a regular basis to discuss the needs of complex patients for example those with end of life care needs or children on the at risk register."

Positive

"This included an induction process onetoone meetings appraisals coaching and mentoring clinical supervision and support for revalidation."

Positive

"Most staff with one exception said they had regular formal clinical supervision and were happy with the mentoring process."

Positive

"Exception reporting is the removal of patients from QOF calculations where for example the patients decline or do not respond to invitations to attend a review of their condition or when a medicine is not appropriate."

Positive

"There was a good skill mix among the GPs with some having additional diplomas and other interests such as orthopaedic medicine and minor surgery."

Positive

"There was a risk that errors in medicine or treatment could be made if the information was incorrectly typed."

Positive

"We saw that clinical audits were undertaken and changes were made when required to ensure that antidepressant medicine was prescribed according to best practice We found that the service was caring towards all patients including patients experiencing poor mental health."

Positive

"This identified two cases which required review and ensured that the practice continued to prescribe this medicine according to best practice guidance."

Positive

"Medicines management Although there was a system in place to check and regulate the temperature of the fridges where medicine was kept we found that this system was not effective."

Positive

"When we checked the fridge temperatures we found they had been continually recorded at heights that would render medicine unsafe for use if the temperature had been as recorded."

Positive

"There was no cold chain policy for the storage of medicine and the procedure was not followed for the recording of fridge temperatures."

Positive

"These meetings were attended by district nurses social workers palliative care nurses and decisions about care planning were documented in a shared care record."

Positive

"The practice had also implemented suggestions for improvements and made changes to the way it delivered services in response to feedback from the patient participation group PPG such as better car parking facilities early opening and automatic doors."

Positive

"Recently a petition had been presented to the local council on behalf of the patients at the practice because of a lack of parking for disabled patients."

Positive

"We saw that the practice had an ongoing plan of clinical audit throughout the year many which were linked to medicines management information or as a result of information from the quality and outcomes framework QOF."

Neutral

"One of the practice nurses confirmed they did their own clinical audit in relation to cervical screening."

Positive

"Health and safety information was displayed for staff to see and the practice manager was responsible for health and safety within the practice."

Positive

"The practice also had a health and safety policy."

Positive

"Regular checks were made by the cleaning company employed by the practice to ensure that the cleanliness was maintained."

Neutral

"We saw there were cleaning schedules in place and cleaning records were kept."

Neutral

"The practice used a cleaning agency and cleaners attended on a daily basis."

Positive

"These included a medication review which improved a patient’s whole quality of life and an opportunistic “message in a bottle” plan for an elderly patient worried about their pet if they had to go into hospital."

Neutral

"Patients were able to access the service by telephone for things such as test and xray results or repeat prescriptions."

Neutral

"There was also information signposting patients to other areas for assistance and leaflets in the practice waiting room for those people without internet access."

Neutral

"There were two television screens in the waiting room and one showed local health information and information on lifestyle management such as diets and alcohol."

Neutral

"There was an up to date recruitment policy in place which stated that only clinical staff required disclosure and barring service checks."