What is the Quality of Care at West Street Surgery

Positive

"• Patients at risk of dementia were identified and offered an assessment to detect possible signs of dementia."

Positive

"People experiencing poor mental health including people with dementia: • Staff interviewed by the inspection team were able to explain their understanding of how to support patients with mental health needs and those patients living with dementia however care plans were not consistently used."

Positive

"When dementia was suspected there was an appropriate referral for diagnosis."

Positive

"Good ––– People experiencing poor mental health including people with dementia The practice is rated as good for the care of people experiencing poor mental health including people with dementia."

Positive

"We rated the service as inadequate for providing Effective services because: • Limited numbers of care plans had been completed for those in vulnerable groups such as those suffering from a mental health condition or with a cancer diagnosis."

Positive

"• Low numbers of care plans had been completed for vulnerable patients such as those with a mental health condition learning disability or cancer diagnosis."

Positive

"People experiencing poor mental health including people with dementia: • The practice assessed and monitored the physical health of people with mental illness severe mental illness and personality disorder by providing interventions for physical activity obesity diabetes heart disease cancer and access to ‘stop smoking’ services."

Positive

"• The practice’s uptake for breast and bowel cancer screening was above the national average."

Positive

"• The practice also encouraged its patients to attend national screening programmes for bowel and breast cancer screening."

Positive

"Information published by Public Health England rates the level of deprivation within the practice population group as seven on a scale of one to ten."

Positive

"Information published by Public Health England rates the level of deprivation within the practice population group as seven on a scale of one to ten."

Positive

"Information published by Public Health England rates the level of deprivation within the practice population group as seven on a scale of one to ten."

Positive

"We rated the service as inadequate for providing Effective services because: • Limited numbers of care plans had been completed for those in vulnerable groups such as those suffering from a mental health condition or with a cancer diagnosis."

Positive

"• Low numbers of care plans had been completed for vulnerable patients such as those with a mental health condition learning disability or cancer diagnosis."

Neutral

"Members of the community midwife team and a mental health link worker operate regular clinics from the practice."

Neutral

"Members of the community midwife team and a mental health link worker operate regular clinics from the practice."

Positive

"People experiencing poor mental health including people with dementia: • The practice assessed and monitored the physical health of people with mental illness severe mental illness and personality disorder by providing interventions for physical activity obesity diabetes heart disease cancer and access to ‘stop smoking’ services."

Positive

"• The mental health link worker who attended the surgery each week managed the system for following up patients who failed to attend for administration of long term medication."

Positive

"• The practice’s performance on quality indicators for mental health was in line with local and national averages."

Positive

"People experiencing poor mental health including people with dementia: • Staff interviewed by the inspection team were able to explain their understanding of how to support patients with mental health needs and those patients living with dementia however care plans were not consistently used."

Neutral

"Members of the community midwife team and a mental health link worker operate regular clinics from the practice."

Neutral

"• A mental health link worker offered a weekly clinic at the practice."

Neutral

"The mental health link worker was qualified to complete medication reviews."

Positive

"• Staff had a good understanding of how to support patients with mental health needs and dementia."

Positive

"Good ––– People experiencing poor mental health including people with dementia The practice is rated as good for the care of people experiencing poor mental health including people with dementia."

Positive

"• Patients with mental health needs were offered consultation with the same clinician helping with continuity of care."

Positive

"• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health including those with dementia."

Positive

"• Counselling services were available at the practice for patients with mental health issues which was provided by a link worker from the local mental health trust."

Neutral

"• The practice had told patients experiencing poor mental health about how to access support groups and voluntary organisations including direct access to counselling and cognitive behavioural therapy."

Neutral

"• Performance for mental health related indicators was comparable to the national average."

Positive

"• Low numbers of care plans had been completed for vulnerable patients such as those with a mental health condition learning disability or cancer diagnosis."

Positive

"The practice supports five local care homes and one local learning disability home."

Positive

"The practice supports five local care homes and one local learning disability home."

Positive

"People whose circumstances make them vulnerable: • The practice held a register of patients living with a learning disability however none of these patients had evidence of a documented care plan in place."

Positive

"The GP’s provided home visits to a local learning disability home."

Neutral

"• A named GP provided home visits to five local care homes and one learning disability home."

Positive

"• There were longer appointments available for patients with a learning disability and others with complex needs."

Positive

"• Low numbers of care plans had been completed for vulnerable patients such as those with a mental health condition learning disability or cancer diagnosis."

Positive

"The practice supports five local care homes and one local learning disability home."

Positive

"The practice supports five local care homes and one local learning disability home."

Positive

"People whose circumstances make them vulnerable: • The practice held a register of patients living with a learning disability however none of these patients had evidence of a documented care plan in place."

Positive

"The GP’s provided home visits to a local learning disability home."

Neutral

"• A named GP provided home visits to five local care homes and one learning disability home."

Positive

"• There were longer appointments available for patients with a learning disability and others with complex needs."

Positive

"• The practice kept a register of patients who had been diagnosed with depression however none of these patients had a record of a care plan in place."

Positive

"For example following an audit of patients prescribed antipsychotic which are a range of medications that are used for some types of mental distress or disorder and depression the practice had rationalised the prescriptions of these medication as per defined guidelines."

Positive

"People experiencing poor mental health including people with dementia: • The practice assessed and monitored the physical health of people with mental illness severe mental illness and personality disorder by providing interventions for physical activity obesity diabetes heart disease cancer and access to ‘stop smoking’ services."

Positive

"• The practice identified patients with commonly undiagnosed conditions for example diabetes chronic obstructive pulmonary disease COPD atrial fibrillation and hypertension through opportunistic assessment."

Positive

"We reviewed a recent safety alert related to managing patients receiving a particular medicine to treat a form of diabetes and found appropriate actions had been taken as recommended."

Positive

"• Clinical staff trained in chronic disease management had lead roles in supporting patients with long term conditions such as diabetes asthma and chronic obstructive pulmonary disease COPD."

Positive

"They had also arranged health seminars on specific health topics such as COPD diabetes and high blood pressure."

Neutral

"• Performance for diabetes related indicators were above the national average."

Neutral

"For example there were nominated GP leads for safeguarding diabetes asthma and COPD."

Positive

"• The practice identified patients with commonly undiagnosed conditions for example diabetes chronic obstructive pulmonary disease COPD atrial fibrillation and hypertension through opportunistic assessment."

Positive

"People with suspected high blood pressure were offered ambulatory blood pressure monitoring and patients with atrial fibrillation were assessed for stroke risk and treated as appropriate."

Positive

"• The practice had reviewed its antibiotic prescribing and taken action to support good antimicrobial stewardship in line with local and national guidance."

Neutral

"For example antibiotic prescribing."

Positive

"People with suspected high blood pressure were offered ambulatory blood pressure monitoring and patients with atrial fibrillation were assessed for stroke risk and treated as appropriate."

Positive

"• The practice had a blood pressure machine in reception to enable patients to take their own blood pressure."

Neutral

"• The practice had systems to inform eligible patients to have the meningitis vaccine for example before attending university for the first time."

Positive

"There were also nurse led clinics for patients with respiratory conditions such as asthma and chronic obstructive pulmonary disease coronary heart disease and diabetes."

Positive

"• Clinical staff trained in chronic disease management had lead roles in supporting patients with long term conditions such as diabetes asthma and chronic obstructive pulmonary disease COPD."

Neutral

"For example there were nominated GP leads for safeguarding diabetes asthma and COPD."

Positive

"There were also nurse led clinics for patients with respiratory conditions such as asthma and chronic obstructive pulmonary disease coronary heart disease and diabetes."

Positive

"The practice had shared care agreements in place with secondary care for patients receiving Warfarin an anticoagulant medicine to reduce the risk of blood clots forming and adult patients receiving oral Methotrexate a medicine used to treat rheumatoid arthritis."