What is the Quality of Facilities at Hatton Medical Practice

Positive

"The practice had identified this as an area for improvement and were seeking to appoint an additional nurse to put more resource into proactive screening."

Positive

"• The practice worked closely with district nurses care navigators and a dementia nurse to help in identifying patients at risk within this group."

Positive

"The senior GP partner told us the practice was attempting to recruit additional nurse resources but had been unsuccessful to date."

Neutral

"The practice also employed a practice manager healthcare assistantphlebotomist business manager a practice nurse a phlebotomist and six receptionists."

Neutral

"During our visit we: • Spoke with a range of staff GPs a nurse practice manager business manager and receptionist and spoke with patients who used the service."

Positive

"The practice manager told us they monitored demand for nursing services and brought the nurse in to provide additional cover if needed."

Neutral

"Patients with long term conditions were referred to the community matron respiratory nurse paediatric asthma service heart failure nurse local diabetic service and dietitians where appropriate."

Neutral

"The practice also employed a practice manager business manager a practice nurse a phlebotomist an administratorhealthcare assistant phlebotomist a data clerk and three receptionists."

Neutral

"• Patients with long term conditions were referred to the community matron respiratory nurse paediatric asthma service heart failure nurse local diabetic service and dietitians where appropriate."

Positive

"• Strengthen governance arrangements regarding performance monitoring to ensure ongoing shortcomings in providing safe services and access to appointments are addressed."

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

"Monitoring risks to patients There were procedures for assessing monitoring and managing risks to patient and staff safety."

Positive

"• Keep the practice’s action plan to improve patient access to appointments under close monitoring and review."

Positive

"The practice told us it had reviewed a CQC intelligence monitoring report on the practice and devised an action plan to tackle the highlighted areas including poor patient satisfaction in the GP patient survey regarding access to services."

Positive

"We also found deficiencies in the minuting of discussions of significant events at full practice meetings; monitoring cleaning schedules; and practice equipment."

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

"• There were cleaning schedules and monitoring systems in place although the cleaning book showing that cleaning tasks had been completed was ticked for each task done but not signed and dated."

Neutral

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

Neutral

"There were cleaning schedules and monitoring systems in place although the cleaning book showing that cleaning tasks had been completed was ticked for each task done but not signed and dated."

Neutral

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

Positive

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

Positive

"• Consider inviting regular locum GPs to the partner meetings to engage them more fully in clinical assessment monitoring and review."

Positive

"There were governance arrangements in place through which risk and performance monitoring took place and service improvements were identified."

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

"We also found deficiencies in the minuting of discussions of significant events at full practice meetings; monitoring cleaning schedules; and practice equipment."

Neutral

"• There were cleaning schedules and monitoring systems in place although the cleaning book showing that cleaning tasks had been completed was ticked for each task done but not signed and dated."

Neutral

"There were cleaning schedules and monitoring systems in place although the cleaning book showing that cleaning tasks had been completed was ticked for each task done but not signed and dated."

Neutral

"However we found two containers of unused cleaning substances in an unlocked under stairs cupboard which potentially patients could access."

Positive

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

Positive

"For example patients on the ‘at risk’ register including children and families vulnerable adults homeless patients those with learning disabilities and poor mental health and those receiving palliative care."

Positive

"Emergency bypass numbers were given to the London Ambulance Service the out of hours and certain patients as identified by the doctor and the local palliative care team to enhance patient care."

Positive

"• All staff apart from a recently recruited receptionist had received basic life support training previously but this had not been updated in the last year."

Neutral

"During our visit we: • Spoke with a range of staff GPs a nurse practice manager business manager and receptionist and spoke with patients who used the service."

Positive

"For example there were complaints about the waiting time to speak to the receptionist by phone and in person during busy periods when the surgery opened in the morning."

Positive

"As a result patients now had a shorter waiting time when getting through to a receptionist at the practice and this was expected to improve further with the introduction of a new telephone system."

Neutral

"In addition the practice had employed an extra receptionist to answer the telephone calls."

Positive

"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 and those in at risk groups including vulnerable children and adults patients with learning disabilities and mental health problems."

Positive

"There were early and ongoing conversations with these patients about their end of life care as part of their wider treatment and care planning."

Positive

"These included 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 and those in at risk groups including vulnerable children and adults patients with learning disabilities and mental health problems."

Positive

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

Positive

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

Positive

"For example health and safety fire risk and Legionella risk assessments."

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

"We were shown the staff handbook that was available to all staff which included sections on work standards sickness on equality harassment and health and safety at work."

Positive

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

Neutral

"We looked at the provider’s policies and records including staff recruitment and training files health and safety building and equipment maintenance infection control complaints significant events and clinical audits."

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 information governance including confidentiality."

Positive

"• The senior GP Partner was the infection prevention and control IPC clinical lead who liaised with the local infection prevention teams to keep up to date with best Are services safe?"

Neutral

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

Positive

"For example recent action taken as a result included a review of patients on specific diabetic medicine which Are services effective?"

Positive

"They were either offered alternative medicine or given the option to continue treatment until they and their clinician considered it appropriate to stop."

Neutral

"However there was no water available for injection of one medicine recommended in CQC guidance for suspected bacterial meningitis."

Positive

"• Ensure that when daily checks of medicine storage fridge temperatures are carried out the signature of the member of staff completing the checks is recorded."

Positive

"For example an audit of prescribing of aspirin and anticoagulant medicine led to better identification and management of patients on dual therapy being prescribed both medicines and improvements in documentation of their treatment including individualised prescribing plans."

Positive

"These activities were not delegated unless the senior partner GP was on leave."