What is the Quality of Facilities at Cestria Health Centre

Neutral

"• Other GPs were members of the local prescribing group the chair of the local medical committee LMC a board member of the local hospice and the director of the local GP federation • The practice manager was the practice manager representative for the local clinical commissioning group."

Positive

"• There was a schedule of regular meetings including practice multidisciplinary team quality improvement palliative care and National Institute for Health and Care Excellence NICE guidance meetings."

Positive

"The practice had a traffic light rated palliative care register and discussed the needs of palliative care patients at regular multidisciplinary team meetings."

Positive

"Recently deceased patients who had been on the register were also discussed at these meetings to identify if there were any lessons to be learned in respect of palliative care."

Positive

"The practice had a traffic light rated supportive care register which included not only palliative care patients but those with conditions such as heart failure chronic obstructive pulmonary disease and dementia."

Neutral

"These included patients requiring palliative care carers and those with a longterm and mental health condition or learning disability."

Positive

"• The practice had a dedicated nurse practitioner who carried out regular home visits to review patients’ care plans and contacted patients on discharge from hospital to ensure they were receiving appropriate support and their needs were being met."

Positive

"The practice had employed dedicated nurse practitioners to review frail and elderly patients and their care plans in their own homes and follow up patients recently discharged from hospital to ensure the were being appropriately supported."

Positive

"The practice had employed nurse practitioners to carry out home visit assessments of their most frail patients to review care plans and ensure appropriate support services were in place."

Positive

"The practice nurse was supported in seeking and attending continuing professional development and training courses and was being supported to undertake an advanced nurse practitioner degree."

Positive

"The practice had also employed dedicated nurse practitioners to review frail and elderly patients and their care plans in their own homes and follow up patients recently discharged from hospital."

Positive

"Effective staffing The staff team included GPs nurse practitioners practice nurses health care assistants and a number of nonclinical staff members including a practice manager personal assistant team leaders receptionists secretaries and administration assistants."

Positive

"A further nurse practitioner had been appointed to extend this area of work."

Positive

"A system was in place to ensure that frail elderly patients and those on the practices high risk register who had recently been discharged from hospital were contacted by a nurse practitioner within three days of discharge to reassess their needs."

Positive

"Urgent appointments were also available the same day following triage by the practice acute team which consisted of GPs and nurse practitioners."

Neutral

"A GP specialist advisor and a practice nurse specialist advisor were also in attendance."

Neutral

"During our visit we spoke with a mix of clinical and nonclinical staff including GPs a practice nurse the practice manager reception team leader receptionists and an administration assistant."

Neutral

"Another practice GP and a nurse practitioner had embarked on further training to enhance the service delivered to diabetic patients including patients from neighbouring practices if needed."

Neutral

"A routine appointment with a nurse was available the same day."

Positive

"• The practice used the Quality and Outcomes Framework QOF as one method of monitoring effectiveness and had achieved an overall result which was comparable with the local average and higher than the national average."

Positive

"Management monitoring and improving outcomes for people The practice used the information collected for the Quality and Outcomes Framework QOF and performance against national screening programmes to monitor outcomes for patients."

Positive

"The SIRMS system enables GPs to flag up any issues via their surgery computer to a central monitoring system so that the local CCG can identify any trends and areas for improvement."

Positive

"Listening and learning from concerns and complaints The practice had an effective system in place for monitoring dealing with and responding to complaints."

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 offered a insulin inititation and monitoring service for diabetic patients."

Neutral

"• Arrangements were in place for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs."

Positive

"An onsite car park is available which includes dedicated disabled car parking spaces."

Positive

"The practice carried out clinical audit activity to help improve patient outcomes."

Positive

"• The practice carried out clinical audit activity and were able to demonstrate improvements to patient care and prescribing as a result of this."

Positive

"There was evidence of clinical audit activity and improvements made to patient care and patient outcomes as a result of this."

Positive

"• There was a programme of clinical audit activity which improved outcomes for patients."

Positive

"This included basic life support health and safety infection control information governance safeguarding and appropriate clinical based training for clinical staff."

Positive

"There was a health and safety policy available and staff were aware of their roles and responsibilities in relation to this."

Positive

"A comprehensive infection prevention and control policy was in place."

Neutral

"A cleaning schedule was in place and regular infection control audits were carried out where action plans were identified and monitored."

Positive

"The practice had employed dedicated nurse practitioners to review frail and elderly patients and their care plans in their own homes and follow up patients recently discharged from hospital to ensure the were being appropriately supported."

Positive

"This enabled early identification and treatment of mental health related issues in the elderly and ensured residents were supported appropriately by care home staff."

Positive

"The practice had also employed dedicated nurse practitioners to review frail and elderly patients and their care plans in their own homes and follow up patients recently discharged from hospital."

Positive

"One of the GPs acted as the frail elderly lead for the local Clinical Commissioning Group CCG which helped clinicians keep up to date and conform with best practice management for this group of patients."

Positive

"• The practice had been instrumental in developing and providing staff and facilities to provide a weekend service for frail elderly and vulnerable patients."

Positive

"This enabled early identification treatment and support of residents with mental health issues in the elderly and had resulted in a reduction in the number of unplanned admission to hospital and A& E attendances for this group of patients."

Positive

"A system was in place to ensure that frail elderly patients and those on the practices high risk register who had recently been discharged from hospital were contacted by a nurse practitioner within three days of discharge to reassess their needs."

Positive

"• Being instrumental in developing and providing staff and facilities to staff a weekend service for frail elderly and vulnerable patients which resulted in fewer admissions to hospital over weekends for this patient group."

Positive

"• The practice had designed and implemented a scheme to work with the local CCG foundation trust and GP federation consisting of six local practices to provide a weekend service for frail elderly and vulnerable patients."