What is the Quality of Facilities at Attleborough Surgeries

Positive

"There are four nurse practitioners six practice nurses an advanced care practitioner and five healthcare assistants."

Positive

"• The practice nurse had developed dementia packs with resources for other professional staff to use to support patients and their families."

Positive

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

Neutral

"This included the district nurse team."

Neutral

"For example the nurse manager regularly reviewed consultations by the nurses and gave feedback."

Positive

"Practice staff recently held a meeting with the learning disabilities nurse to discuss ways of supporting those who had failed to attend for their reviews."

Positive

"There were two more nurse practitioners five practice nurses five health care assistants and nine dispensing staff who were employed to work varying hours."

Positive

"During our visit we spoke with a range of staff including two GP’s two nurse practitioners a health care assistant the practice manager dispensing manager reception manager and a receptionist."

Positive

"Staff interviews confirmed that the practice was proactive in providing training and funding for relevant courses for example specialist diabetes training for one of the nurse practitioners."

Positive

"The nurse practitioner had attended specialist training in diabetes. . We found that patients with learning disabilities or mental health conditions were offered an annual health review."

Positive

"For example the trainee nurse practitioner was arranging to attend some study days around infection control to enable them to carry out their lead role in this area effectively."

Positive

"A nurse practitioner specialised in diabetes chronic obstructive airways disease family planning and contraception."

Positive

"For example there was a lead nurse for infection control; a GP was the lead for safeguarding and another for health and safety."

Neutral

"A practice nurse specialised in long term conditions and diabetes provides updates at clinical meetings relating to management guidelines for this patient group."

Neutral

"There was a practice manager receptionsurgeries manager IT manager dispensary manager and a nurse manager who was a nurse practitioner."

Neutral

"We spoke with a nurse practitioner who was the lead for infection control."

Neutral

"The nurse practitioner carried out full audits of the practice every six months."

Neutral

"The nurse practitioner told us they carried out spot checks on the hygiene levels within the practice."

Neutral

"A nurse practitioner told us they explained tests and treatments to patients before carrying them out and ongoing information was provided during the procedures so that patients knew what to expect."

Neutral

"They included clinical meetings multidisciplinary meetings for long term conditions nurse meetings and nonclinical meetings."

Positive

"• Staff encouraged and supported patients to be involved in monitoring and managing their own health for example through social prescribing schemes."

Positive

"• The practice had arrangements for adults with newly diagnosed cardiovascular disease including the offer of highintensity statins for secondary prevention people with suspected hypertension were offered ambulatory blood pressure monitoring and patients with atrial fibrillation were assessed for stroke risk and treated as appropriate."

Positive

"The practice proactively used a risk assessment tool to identify patients with hypertension and offered home blood pressure monitoring machines for patients."

Positive

"• Arrangements were in place for planning and monitoring the number and mix of staff needed to meet patients’ needs including planning for holidays sickness busy periods and epidemics."

Positive

"• Patients had access to a blood pressure monitor in reception allowing easy monitoring and effective consultation time."

Positive

"Since the inspection the practice have evidenced that a further assessment for legionella has been completed and that water temperature monitoring is no longer required."

Positive

"• There was no system embedded for the monitoring of blank prescription stationary."

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

"• Although stationary was stored safely we found that there was no monitoring of blank prescription stationary."

Neutral

"The practice were also actively reviewing and monitoring their same day clinic appointments and had included routine prebookable appointments for the emergency care practitioner."

Positive

"Management monitoring and improving outcomes for people Practice staff actively participated in recognised clinical quality and effectiveness schemes such as the national Quality Outcomes Framework QOF and the local Clinical Commissioning Group CCG enhanced service schemes."

Positive

"Learning and improvement from safety incidents There was a system in place for reporting recording and monitoring significant events."

Positive

"The system included a facility to flag up patients who required closer monitoring such as children at risk."

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

"The practice supported staff in the homes in both their care giving activities and education to encourage coordinated management of complex patients."

Positive

"• The practice acted on and learned from external safety events as well as patient and medicine safety alerts."

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

"One audit concerned a review of the use of a medicine and the actions that had been taken as a result of the audit."

Positive

"The practice provides a free medicine delivery for patients who are housebound."

Neutral

"Both venues offer medicine dispensing services for patients who lived in excess of one mile from a pharmacy."

Neutral

"Audits in relation to medicine management practices had been carried out."

Neutral

"A comparison had been made with the rate the medicine was prescribed against the use by other practices within the locality."

Neutral

"The respective GP had provided a list of all patients who were prescribed the medicine with a request that they should be reviewed to check if the patients still required the medicine and the dosage."

Positive

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

Positive

"A patient who had a wrist injury expressed their dissatisfaction that practice staff did not arrange transport for them to attend the hospital the following morning."

Positive

"The GP emergency care practitioner 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

"A multidisciplinary meeting was held every month to discuss patients receiving end of life care and those considered to be at risk."

Positive

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

Positive

"There was a health and safety policy in place and staff knew where to access it."

Positive

"• There was an effective system to manage infection prevention and control across both sites."

Positive

"The infection prevention and control lead was trained in waste management procedures."

Neutral

"Cleanliness & Infection Control We looked at how infection prevention and control was managed at the practice."

Neutral

"The practice also held a meeting every eight weeks to discuss these patients and referred to the local frail elderly team for further input where required."

Positive

"Practice staff liaise closely with the community frail elderly team who also regularly attend practice meetings to ensure the care for these patients is up to date in meeting their needs."

Positive

"We spoke with the chair of the PPG who told us that the management team liaised well with the group to look at ways to further develop and improve the service patients received."

Neutral

"We also spoke with eight patients who used the service and chair of the Patient Participation Group PPG who acted as patient advocates in driving up improvements."

Neutral

"We spoke with the chair and vice chair of the PPG."

Positive

"Each partner had dedicated lead roles such as; palliative care clinical governance research and prescribing."

Positive

"A receptionist told us they could ask a patient to speak with them privately in an unoccupied room to protect their confidentiality."

Neutral

"We asked a receptionist how they would carry out this duty."

Positive

"Each partner had dedicated lead roles such as; palliative care clinical governance research and prescribing."

Positive

"We saw that Control of Hazardous Substances Hazardous to Health COSHH data sheets were in place to advise staff how to safely handle all cleaning products."

Neutral

"We saw that there was a cleaning schedule in place for cleaning staff to follow."

Neutral

"They told us there was a communication book that was used to inform the cleaning staff of any necessary tasks."