What is the Quality of Facilities at Concord Medical Centre

Positive

"The practice nurse told us diabetes asthma and chronic obstructive pulmonary disease COPD had personalised care plans and were provided with appropriate supporting information."

Positive

"There are eight female members of the nursing team which include one nurse coordinator three practice nurses and one physician’s assistant two health care assistants and a phlebotomist."

Positive

"Chronic disease clinics were available with the nurse and GP for conditions such as asthma chronic obstructive pulmonary disease COPD and stroke."

Positive

"The mental health nurse Are services effective?"

Positive

"We saw many areas where the practice had led innovative service redesign; the use of the DEXA scanner the ENT service the use of Dermatoscopy employing a mental health nurse consultant and integrated service with the Bristol Oncology Centre."

Positive

"The mental health nurse consultant also had an important role in working closely with health visitors and GPs to help prevent families from reaching crisis point and needing intervention."

Positive

"National patient safety alerts such as from the Medicines and Healthcare Products Regulatory Agency MHRA were disseminated by the lead GP or nurse to relevant practice staff."

Neutral

"They had also recruited a mental health nurse consultant following a review of their patient needs."

Neutral

"The practice has also employed a mental health nurse consultant to oversee patients with mental health conditions to provide assessment monitoring and treatment to those who needed it."

Neutral

"This had changed practice in many areas including the recruitment of a fulltime mental health nurse consultant."

Neutral

"For example there was a lead nurse for infection control and a GP partner was the lead for safeguarding."

Positive

"There were monthly meetings with a multidisciplinary team consisting of community district nurses the practice mental health nurse consultant and the palliative care team to discuss and meet the needs of patients with complex health care needs."

Positive

"The lead practice nurse had the responsibility for ensuring there was effective infection control throughout the practice."

Positive

"The practice held multidisciplinary monthly meetings with other health care professionals such as district nurses mental health nurse consultant palliative care nurses health visitors and midwifes."

Positive

"Patients had benefitted because the practice had employed a specialist in mental health nurse consultant as this provided more consistent care and treatment."

Positive

"In addition the practice had a mental health nurse consultant who supported patients experiencing mental health issues."

Positive

"The practice had a chaperoning policy and service available to all patients which ensured patients who received intimate treatment had the opportunity to see a GP or nurse accompanied by a skilled and knowledgeable chaperone."

Positive

"From this learning the nurse cascaded the training to GPs nurses and health care assistants."

Positive

"The practice nurse told us they often gained advice from community services if they had complex treatments to provide."

Positive

"A chaperone is a member of staff who has a supportive role for a GP or nurse and a patient during a medical examination or treatment."

Positive

"The practice was involved in various multidisciplinary monthly meetings which involved palliative care nurses health visitors mental health nurse and district nurses."

Positive

"The mental health nurse consultant employed by the practice supported new mothers who were diagnosed with postnatal depression."

Positive

"Health care advice was provided by the nurse practitioners to children who were classed as obese."

Positive

"The practice employed a full time mental health nurse consultant to see patients when they needed additional mental health support."

Positive

"The mental health nurse provided support for patients who were waiting for their appointment in specialist services."

Positive

"The practice nurse told us equipment such as ECG machines blood pressure monitors spirometry and weighting machines were calibrated every six months."

Neutral

"Additional services included scanning for osteoporosis ear nose and throat ENT procedures including mircosuction specifically for cleaning of the ears and a full time mental health nurse consultant."

Neutral

"Patients experiencing poor mental health had access to a practice mental health nurse consultant who provided additional therapies and support."

Neutral

"They employed a fulltime mental health nurse consultant who worked closely with patients and the GP team."

Neutral

"The practice employed a fulltime mental health nurse consultant."

Neutral

"Practice nurses were similarly flexibly available and there was always at least one practice nurse who worked alongside the GPs during opening hours."

Neutral

"The lead nurse attended external annual training on infection control and participated in a forum for South Gloucestershire nurses which took place quarterly."

Neutral

"We were also informed that infection control training was cascaded to staff through the lead nurse who completed annual training."

Neutral

"The lead nurse was now liaising with the district nursing team to arrange regular training in wound management."

Neutral

"This service was provided by one of the nursing team on request of a GP or nurse if a patient wished this."

Neutral

"There was never any need to use a receptionist because there was always a duty nurse or GP available to assist with any requests."

Neutral

"All GP partners associates and nurse practitioners had lead roles within the practice."

Neutral

"Child immunisations were provided by the nurse and reminders were sent to the parent if there was nonattendance for appointments."

Neutral

"The mental health nurse had regular meetings with the lead GP to avoid professional isolation and to share patient information."

Positive

"Learning and improvement from safety incidents The practice had a system in place for reporting recording and monitoring significant events incidents and accidents."

Positive

"Management monitoring and improving outcomes for people The practice had a system in place for completing clinical audit cycles."

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

"The practice has also employed a mental health nurse consultant to oversee patients with mental health conditions to provide assessment monitoring and treatment to those who needed it."

Neutral

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

Positive

"Patients received care and treatment that was delivered in line with the latest national standards such as monitoring the alerts provided from the Medicines and Healthcare Products Regulatory Agency MHRA."

Positive

"Learning and improvements from safety incidents The practice had a system in place for reporting recording and monitoring significant events."

Positive

"Management monitoring and improving outcomes for people The practice manager and GPs told our specialist GP advisor that clinical audits were completed by GP and nursing staff and kept in a central repository for other GPs to refer to."

Positive

"The practice manager had a system for monitoring annual leave which ensured staffing levels were kept stable."

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

"Meetings were held with the palliative care teams to ensure coordinate care that respected patient’s needs and wishes."

Positive

"The practice held monthly multidisciplinary meetings and would invite district nurses emergency care practitioners the intermediate rehabilitation care and support team adult social services and palliative care nurses."

Positive

"The practice also had lead roles for all clinical care areas such as epilepsy atrial fibrillation mental health and palliative care."

Positive

"There were monthly meetings with a multidisciplinary team consisting of community district nurses the practice mental health nurse consultant and the palliative care team to discuss and meet the needs of patients with complex health care needs."

Positive

"The practice held multidisciplinary monthly meetings with other health care professionals such as district nurses mental health nurse consultant palliative care nurses health visitors and midwifes."

Positive

"The practice was involved in various multidisciplinary monthly meetings which involved palliative care nurses health visitors mental health nurse and district nurses."

Positive

"They held multidisciplinary meetings with the emergency care practitioners GPs palliative care and district nurses where they discussed admittance to hospital and how this could be reduced and community services used instead."

Neutral

"The practice discussed adults at risk monthly with a multidisciplinary team which included emergency care practitioners district nurses palliative care nurses and social workers."

Positive

"A receptionist and a health care assistant had been trained in British Sign Language which enabled them to provide support to patients who used this language."

Positive

"The practice had developed a member of staff from a receptionist to a phlebotomist and to a health care assistant with an extended role in smoking cessation."

Positive

"One member of staff had started as a receptionist and had been trained in other areas of the practice such as complex administration work phlebotomy taking blood samples and was in process of completing training as a health care assistant."

Neutral

"This area was not sound proof and other patients could still hear conversations between the receptionist and patient."

Neutral

"There was never any need to use a receptionist because there was always a duty nurse or GP available to assist with any requests."

Positive

"Staff told us they felt confident to deal with a medical emergency and had received basic life support training in the last year."

Positive

"Patients were seen in the upgraded treatment suite and were able to use the community garden specially made for oncology patients in support of their emotional wellbeing."

Positive

"A local garden centre had donated plants for the community garden."

Positive

"The local garden centre had donated plants for the new community garden."

Neutral

"Patients were seen in the upgraded treatment suite and there was an outside community garden for patients to use during treatment."

Positive

"The practice learnt from patient feedback and quality assurance activities and had made a number of significant changes recently."

Positive

"Patients who were receiving end of life care had a named GP and there were arrangements to share information with out of hour’s services for when the practice was closed to ensure continuity of treatment."

Positive

"These patient groups included vulnerable older patients patients needing end of life care and patients who were at risk of unplanned admission to hospital."

Positive

"Following each clinical audit changes to treatment or care were made where needed and the audit was repeated to ensure outcomes for patients had improved."

Positive

"Management monitoring and improving outcomes for people The practice had a system in place for completing clinical audit cycles."

Positive

"The team was making use of clinical audit tools clinical supervision and staff meetings to assess the effectiveness of interventions made by clinical staff."

Positive

"The team was making use of clinical audit tools clinical supervision and staff meetings to assess the effectiveness of interventions made by clinical staff."

Positive

"Health and safety information was displayed for staff to see and there were identified health and safety representatives."

Positive

"Staff received training in mandatory courses such as fire safety manual handling health and safety infection control and equality and diversity through an online virtual college."

Positive

"We saw a trainee GP induction programme which covered a welcome to the practice by a GP partner health and safety protocols human resources protocols prescribing IT system tutorials with other GPs specialist areas such as child health and immunisations."

Neutral

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

Neutral

"Additional services included scanning for osteoporosis ear nose and throat ENT procedures including mircosuction specifically for cleaning of the ears and a full time mental health nurse consultant."

Neutral

"All communal and nonclinical areas of the practice were maintained and cleaned routinely by a cleaning contractor."

Neutral

"We were informed by the practice manager that cleaning staff had been spoken with at the time."

Positive

"• The practice had developed an integrated service provision with the Bristol Oncology Centre hospital staff to provide in house oncology treatment a branch of medicine which deals with cancer for their own patients and patients from other practices within the community."

Positive

"We checked medicines stored in the treatment rooms and medicine refrigerators and found they were stored securely and were only accessible to authorised staff."

Positive

"For example ensuring a GP was consulted where medicines had been prescribed the same medicine the maximum number of times stated."

Positive

"We saw evidence to confirm that after receiving an alert the GPs had reviewed the use of the medicine in question."

Positive

"The practice had developed an integrated service provision with the Bristol Oncology Centre hospital staff to provide inhouse oncology treatment a branch of medicine which deals with cancer for their own patients and patients from other practices within the community."

Neutral

"All these patients had a named GP and a structured annual review to check their health and medicine needs were being met."

Positive

"The practice had developed an integrated service provision with the Bristol Oncology Centre hospital staff to provide in house oncology treatment a branch of medicine which deals with cancer for patients within the community."

Neutral

"Patients with COPD were also given a rescue medicine selfstart pack allowing them to selfstart treatment if symptoms indicated an escalation of their condition allowing prompt treatment for infections."

Neutral

"They also planned on asking patients about whether they would be more likely to read the television monitor displayed in the waiting area."

Positive

"We observed there was no lowered reception desk for ease of access for wheelchair users and children."