What is the Quality of Facilities at The Porch Surgery

Positive

"There are two nurse prescribers three practice nurses two health care assistants and a phlebotomist."

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

"Outstanding practice We saw five areas of outstanding practice: • The practice nurse manager visited a local nursery school to provide basic life support classes for children."

Positive

"We saw five areas of outstanding practice: • The practice nurse manager visited a local nursery school to provide basic life support classes for children."

Positive

"• Where a patient’s mental capacity to consent to care or treatment was unclear the GP or practice nurse assessed the patient’s capacity and recorded the outcome of the assessment."

Positive

"• Vulnerable patients who did not attend their scheduled appointments were contacted by a practice nurse to check their welfare."

Positive

"• The practice nurse manager visited a local nursery school to provide basic life support classes for children."

Positive

"In addition there is one nurse manager three practice nurses one health care assistant three phlebotomists and an emergency care practitioner or ECP employed."

Positive

"• The practice nurse manager visited a local nursery school to provide basic life support classes to children."

Positive

"• The practice was proactive in ensuring that vulnerable patients who did not attend their scheduled appointments were contacted by the practice nurse assessed and if necessary booked for a same day appointment at the practice."

Positive

"• The practice was proactive in ensuring that vulnerable patients who did not attend their scheduled appointments were visited by the practice nurse assessed and if necessary booked for a same day appointment at the practice."

Neutral

"The nurse manager used an anatomical skeleton model to inform children about the structure and function of bones; and a medical resuscitation doll when informing children about who to contact when faced with an unconscious patient."

Neutral

"An ECP is a paramedic with enhanced skills in medical assessment and extra clinical skills over and above those of a standard paramedic qualified nurse or otherambulancecrew such as technicians."

Neutral

"Routine GP and nurse appointments are available on alternate Saturday mornings."

Neutral

"The lead nurse was the infection control lead who liaised with the local infection prevention teams to keep uptodate with current practice."

Neutral

"For example by accessing online resources and discussion at practice nurse meetings."

Neutral

"The nurse manager used an anatomical skeleton model to inform children about the structure and function of bones; jelly in a bowl to represent a heart; and a medical resuscitation doll when informing children about who to contact when faced with an unconscious patient."

Neutral

"Routine GP and nurse appointments were available on alternate Saturday mornings."

Positive

"For example an audit of patients being prescribed mirabegron a medicine given to treat overactive bladder conditions demonstrated improved adherence to the best practice guidelines for monitoring this group of patients."

Positive

"Risks to patients There were adequate systems to assess monitor and manage risks to patient safety • 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

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

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 did not follow guidance around the safe storage and monitoring of vaccinations requiring refrigeration."

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

"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

"• There were procedures in place for monitoring and managing risks to patient and staff safety."

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

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

Positive

"• The practices’ uptake for breast and bowel cancer screening was in line the national average."

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 worked with a local voluntary group who provide transport for patients attending practice and hospital appointments."

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."

Positive

"• The practice initiated setup and developed ‘The Brunel Shed’ which uses woodwork and other activities to help patients combat social isolation share resources and learn new skills."

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

"• We saw evidence that the practice was working to the Gold Standards Framework for those patients with end of life care needs."

Positive

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

Positive

"This included ongoing support during sessions onetoone meetings appraisals coaching and mentoring clinical supervision and facilitation and support for revalidating GPs."

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."

Neutral

"They covered such topics as safeguarding infection prevention and control fire safety health and safety and confidentiality."

Positive

"For example an audit of patients being prescribed mirabegron a medicine given to treat overactive bladder conditions demonstrated improved adherence to the best practice guidelines for monitoring this group of patients."

Positive

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

Positive

"For example the practice ran a quarterly computer audit of all patients prescribed an anticoagulant medicine medicines used to prevent the risk of blood clots to check they had had the regular blood test recommended for these medicines and that the results were within the therapeutic range."

Positive

"• The practice had produced some diabetic advice sheets for patients which gave a clear and simple explanation of their blood test results and the medicine they were prescribed."

Neutral

"The practice displayed a sign advising patients to request to see a receptionist prior to using the booth who would rearrange the layout to facilitate wheelchair access."

Neutral

"A practice receptionist acted as a carer’s coordinator."

Positive

"For example patients indicated that the practice’s blood pressure booth was not wheelchair friendly."

Neutral

"The practice displayed a sign advising patients to request to see a receptionist prior to using the booth who would rearrange the layout to facilitate wheelchair access."

Positive

"There was a health and safety policy available in the practice manager’s room which identified local health and safety representatives."

Neutral

"They covered such topics as safeguarding infection prevention and control fire safety health and safety and confidentiality."