What is the Quality of Facilities at Harbourside Family Practice

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

"All patient services including nurse treatment and GP consulting rooms are located on the ground and first floors."

Positive

"The practice nurses supported this work by holding nurse led clinics run by the three trained nurses and the nurse practitioner."

Positive

"Patients who attended the practice with minor illnesses were assessed and treated by the nurse practitioner."

Positive

"It was practice policy to offer a health check with the health care assistant or practice nurse to all new patients registering with the practice."

Positive

"The practice had a nurse with lead responsibility for infection control who had undertaken training to enable them to provide advice on the practice infection control policy and carry out staff training."

Neutral

"The team included a GP special advisor a CQC inspector a nurse special advisor and an expert by experience."

Neutral

"We spoke with the nurse practitioner and two practice nurses."

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

"• 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."

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

"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

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

Positive

"There was a system in place for the management of high risk medicines which included regular monitoring which followed the national guidance."

Positive

"For example we saw patient on a medicine that required therapeutic monitoring and saw results of the monitoring tests had been audited with the result that patient who were stable had reduced monitoring."

Positive

"There were systems in place for monitoring higher risk patients such as those with long term conditions in receipt of end of life care and patients being treated for cancer."

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."

Neutral

"New patients’ health concerns were identified and arrangements made to add them into any long term health monitoring processes such as the diabetes asthma or heart conditions clinics or reviews."

Neutral

"The practice had a number of measures in place as part of its governance arrangements for example audits procedures reviews monitoring mechanisms questionnaires and meetings."

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

"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

"• Staff were clear on their roles and accountabilities including in respect of safeguarding and infection prevention and control • Practice leaders had established proper policies procedures and activities to ensure safety and assured themselves that they were operating as intended."

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."

Positive

"Similar mechanisms of identifying "at risk" groups were used for patients such as those receiving end of life care and these patients were offered service support according to their needs."

Positive

"There were systems in place for monitoring higher risk patients such as those with long term conditions in receipt of end of life care and patients being treated for cancer."

Positive

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

Neutral

"The team was making use of clinical audit tools clinical supervision and staff meetings to monitor the performance of the practice."

Positive

"• Staff were clear on their roles and accountabilities including in respect of safeguarding and infection prevention and control • Practice leaders had established proper policies procedures and activities to ensure safety and assured themselves that they were operating as intended."

Positive

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

Positive

"For example we saw patient on a medicine that required therapeutic monitoring and saw results of the monitoring tests had been audited with the result that patient who were stable had reduced monitoring."

Positive

"Medicines management 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

"We saw evidence to confirm that after receiving an alert the GPs had reviewed the use of the medicine in question and where they continued to prescribe it outlined the reason why they decided this was necessary."

Neutral

"A number of research papers showed that the same medicine at a lower dosage had a very similar efficacy with a much lower profile of adverse reactions."

Neutral

"However as this can be time consuming and frustrating for the patient the practice took a proactive approach and three patients were identified who are currently being prescribed the medicine and needed it to be changed."

Positive

"The practice had a palliative care register and had regular internal as well as multidisciplinary meetings to discuss the care and support needs of patients and their families."

Positive

"Patients receiving palliative care those with cancer diagnosis and patients likely to require unplanned admissions to hospital had an individualised clinical note added to the GP out of hours provider’s record managements system to share information and patient choicepreferences for treatment with other service providers."

Positive

"Regular meetings with other professionals such as the community matron community nursing teams health visitors palliative care team took place."

Neutral

"The services for patients were on the ground and first floor; however there was lift access to the first floor."

Positive

"Safety alerts and information was also available via the internet for staff to readily access."

Positive

"We saw wheelchair access at the entrance to the practice an accessible toilet and sufficient space in the waiting room to accommodate patients with wheelchairs and pushchairs which allowed for easy access to the treatment and consultation rooms."

Neutral

"There were GP leads for clinical governance and the partners mentored salaried GPs."

Neutral

"The team was making use of clinical audit tools clinical supervision and staff meetings to monitor the performance of the practice."

Positive

"Health and safety information was displayed for staff to see and there was an identified health and safety representative."

Positive

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

Neutral

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