What is the Quality of Facilities at The Misbourne Practice

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

"The allfemale nursing team consists of one nurse prescriber three practice nurses and a health care assistant who also performs phlebotomy duties."

Positive

"Following this incident there was a full review which included a review of the practices prescribing processes and as a result one agreed process which all prescribers GPs and nurse prescriber had implemented."

Positive

"For example the nurse prescriber who was also one of the locality lead nurses within Chiltern CCG had launched a CCG wide leg ulcer handbook following a five practice audit of leg ulcers."

Neutral

"• Four of the five nurses had additional Safeguarding training the remaining nurse was completing this training Safeguarding Children level three during the inspection."

Neutral

"For example GPs were trained to Safeguarding Children level three four of the five nurses were also trained to Safeguarding Children level three the remaining nurse was completing Safeguarding Children level three training during the inspection and both GPs and nurses had completed adult safeguarding training."

Neutral

"The nurse prescriber and one of the practice nurses had been appointed as the joint infection control leads."

Neutral

"The nurse prescriber who was attending this study day had arranged to provide any key learning to the rest of nursing team at the next nurse team meeting."

Neutral

"Regular meetings took place for staff groups including whole staff partner nurse clinical governance and reception and administration staff meetings."

Positive

"• The practice had a clear vision and strategy to deliver a high standard of care to The Misbourne Practice patients whilst monitoring and auditing services with a view to improve the patient experience."

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."

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 received support or were signposted to the relevant service."

Neutral

"Regular meetings took place for staff groups including whole staff partner nurse clinical governance and reception and administration staff meetings."

Positive

"Members of the nursing team were also active within the clinical audit programme and we reviewed several audits lead by nurses within their specialist fields for example diabetes and leg ulcers."

Positive

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

Positive

"There was a health and safety policy displayed which identified local health and safety representatives."

Positive

"• The health and safety policy was underpinned by robust risk assessments of the risks associated with the practice premises."

Neutral

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

Neutral

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

Positive

"They told us the practice was responsive to patients needs including complex medicine needs and treated them with dignity and respect."

Positive

"One of the additional emergency medicines was a medicine used as a secondgeneration antihistamine a medicine used to treat a number of allergic health conditions."

Positive

"• National patient safety and medicine alerts were disseminated within the practice in a formal way and there was a system to record that these had been appropriately dealt with."

Neutral

"One of the actions also included an invitation to the seven patients for a medicine review and awareness discussion about different treatments available."