What is the Quality of Facilities at High Street Surgery

Positive

"• We reviewed one palliative care plan and found that the practice shared relevant information with other services in a timely way."

Positive

"• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life."

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

"During our visit we: • Spoke with a range of clinical staff including three GP partners the practice pharmacist one practice nurse one health care assistant the practice manager and a range of staff from the reception and administration teams as well as patients who used the service."

Neutral

"There is one nurse practitioner female three practice nurses female and three healthcare assistant female."

Neutral

"• The practice nurse was the IPC clinical lead."

Positive

"The nurse prescriber and nurse practitioner are qualified nurses who have undertaken advanced education and training in the assessment and treatment of patients suffering from a wide range of common or minor illnesses including diabetes and chronic obstructive pulmonary disease COPD respiratory medicine and cardiology heart related diseases."

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 where appropriate recorded the outcome of the assessment."

Positive

"The practice was always looking at ways to improve the service it gave for example walk in service practice nurse taking appointments to relieve the GPs."

Positive

"The practice nurse was the infection control clinical lead who liaised with the local infection prevention teams to keep up to date with best practice."

Positive

"During our visit we spoke with three GPs the practice manager one nurse practitioner one practice nurse two health care assistants one dispenser three receptionists a prescription clerk a member of administration staff and four patients who used the service."

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

"However the systems for monitoring the temperatures of medicines refrigerators were not always effective."

Positive

"The practice was unable to demonstrate they had effective procedures to manage quality improvements or governance systems relating to the monitoring of risk to patients for infection prevention and control fire safety and legionella management."

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 had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs."

Neutral

"• There were arrangements for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs."

Positive

"Areas for improvement Action the service MUST take to improve • Revise the system for monitoring and responding to complaints to ensure records are complete and accurate and lessons learned are shared with the wider staff."

Positive

"Management monitoring and improving outcomes for people The practice participated in the Quality and Outcomes Framework QOF."

Positive

"• There were procedures for monitoring and managing risks to patients 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."

Neutral

"However the practice did not have an automatic door opening system for wheelchair users."

Positive

"For example fire risk assessments and evacuation infection prevention and control legionella management and responding to medical emergencies."

Positive

"For example one member of staff was not up to date with fire safety training two members of staff were not up to date with infection prevention and control training and members of the clinical team including locum GP s could not evidence that they had completed safeguarding training."

Positive

"• The practice failed to ensure infection prevention and control audits were effective in that not all issues were identified and issues that were identified were not action in a timely manner."

Positive

"The practice was unable to demonstrate they had effective procedures to manage quality improvements or governance systems relating to the monitoring of risk to patients for infection prevention and control fire safety and legionella management."

Neutral

"The practice had completed bi annual infection prevention and control IPC audits."

Neutral

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

Neutral

"For example the infection prevention and control policy."

Positive

"The practice was unable to demonstrate there were cleaning regimes for these."

Positive

"For example after a significant event involving too much medicine being dispensed to one patient the practice sought advice from the local clinical commissioning group’s medicines management team and another local GP practice to inform their review of their prescribing policy for this medicine."

Positive

"The nurse prescriber and nurse practitioner are qualified nurses who have undertaken advanced education and training in the assessment and treatment of patients suffering from a wide range of common or minor illnesses including diabetes and chronic obstructive pulmonary disease COPD respiratory medicine and cardiology heart related diseases."

Neutral

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

Neutral

"As a result we found that one GP had a medicine in their bag which was more than six months past its expiry date."

Positive

"The pharmacist was regularly contacting patients and their families receiving end of life care to help ensure these patients were receiving appropriate and timely care and support."

Positive

"As part of the project the pharmacist was reviewing care plans for elderly and vulnerable patients and regularly contacting patients and their families receiving end of life care to help ensure these patients were receiving appropriate and timely care and support."

Neutral

"For example: • Patients receiving end of life care carers those at risk of developing a longterm condition and those requiring advice on their diet smoking and alcohol cessation."

Positive

"The pharmacist regularly contacted patients and their families receiving end of life care to help ensure these patients were receiving appropriate and timely care and support."

Positive

"• There was evidence that clinical audit was used to monitor quality and to make improvements."

Positive

"For example health and safety risks including fire safety and legionella monitoring."

Positive

"• There was a health and safety policy available."

Neutral

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

Positive

"There was a health and safety policy available with a poster in the reception office."

Neutral

"• The practice had an induction programme for newly appointed nonclinical members of staff that covered such topics as safeguarding fire safety health and safety and confidentiality."

Positive

"As part of the project the pharmacist was reviewing care plans for elderly and vulnerable patients and regularly contacting patients and their families receiving end of life care to help ensure these patients were receiving appropriate and timely care and support."

Positive

"This included ongoing support during sessions onetoone meetings appraisals coaching and mentoring clinical supervision and facilitation as well as support for the revalidation of doctors."