Latest Snippet(s)
Positive
"The practice clinical team also includes three advanced nurse practitioners and one nurse practitioner who prescribe two clinical pharmacists and three paramedics."
Neutral
"There are six practice nurses five healthcare assistants and a phlebotomist who are led by a practice nurse manager."
2021-01-29 Snippet(s)
Positive
"The practice clinical team also includes four advanced nurse practitioners and two nurse practitioners who prescribe."
Neutral
"There are five practice nurses five healthcare assistants and a phlebotomist who are led by a practice nurse manager."
2019-12-06 Snippet(s)
Positive
"The practice clinical team also includes five advanced nurse practitioners and one nurse practitioner who prescribes."
Neutral
"There are six practice nurses four healthcare assistants and two phlebotomists who are led by a practice nurse manager."
2019-04-26 Snippet(s)
Positive
"The practice clinical team also includes five advanced nurse practitioners and one nurse practitioner."
Neutral
"There are six practice nurses a healthcare specialist three healthcare assistants and a phlebotomist who are led by a practice nurse manager."
2018-03-12 Snippet(s)
Positive
"The provider told us that the advanced nurse practitioners visited the care homes and consulted with a GP when it was appropriate."
Positive
"The referrals made by the advanced nurse practitioners were audited by a GP to ensure they were appropriate."
Positive
"Monitoring of the work undertaken by the advanced nurse practitioners was formalised and effective."
Positive
"One nurse was being supported to become an advanced nurse practitioner."
Positive
"The infection control lead nurse completed monthly checks to ensure infection control measures were effective."
Positive
"• Advanced nurse practitioners provided regular weekly home visits as part of a contract to patients who lived in four of the care homes covered by the practice."
Positive
"• There was a named GP mentor for the advanced nurse practitioners ANP and a named ANP who supported the nursing team."
Positive
"One of the advanced nurse practitioners had completed internal care navigation training with staff who book patient appointments."
Positive
"Reviews of the prescribing of advanced nurse Are services safe?"
Positive
"Requests for urgent appointments were triaged by the on call advanced nurse practitioner and GP and allocated for an appointment or home visit as appropriate."
Positive
"The practice was currently supporting one of the nurses to complete their advanced nurse practitioner training."
Positive
"The practice employs six advanced nurse practitioners one nurse practitioner three practice nurses one of which is the nurse manager and a trainee practice nurse."
Positive
"There was a lead GP and deputy lead advanced nurse practitioner ANP for safeguarding."
Positive
"All staff had received safeguarding training; GPs and advanced nurse practitioners and nursing team staff were trained to level three."
Positive
"• The advanced nurse practitioners followed up on older patients discharged from hospital."
Positive
"• Annual health assessments for people with a learning disability were undertaken by the advanced nurse practitioner who had attended additional training to undertake this work."
Positive
"There were limited advanced booking appointments and these were not available with an advanced nurse practitioner although the practice was speaking with the computer company to enable this."
Positive
"• The practice had amended the nurse appointment system to increase the flexibility of appointments for patients."
Positive
"The practice had an advanced nurse practitioner and GP on call every day."
Positive
"The practice had also identified the need to undertake patient education in relation to the role of the advanced nurse practitioner."
Neutral
"For example diabetic appointment were available at any time when the nurse who specialised in diabetes was working rather than previously being at set times."
Neutral
"Each nurse had a named GP who completed regular supervision sessions and audits of clinical consultations and prescribing."
2017-11-07 Snippet(s)
Positive
"The practice employs six advanced nurse practitioners one nurse practitioner three practice nurses one trainee practice nurse and a nurse manager."
Neutral
"Each nurse had a named GP who completed regular supervision sessions and audits of clinical consultations and prescribing."
Neutral
"How we carried out this inspection During our visit we: • Spoke with a range of staff including a GP a nurse and practice management staff."
2017-08-10 Snippet(s)
Positive
"• The practice had recently employed a palliative care specialist nurse to further improve palliative care."
Positive
"The nurse had completed an audit into diabetic care and had a plan to implement improvements in care."
Positive
"The practice had recently employed a palliative care specialist nurse to further enhance this aspect of care."
Positive
"• The practice nurse was the infection prevention and control IPC clinical lead who liaised with and attended the local infection prevention team meetings to keep up to date with best 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 practice had recently employed a palliative nurse specialist to further improve the service."
Positive
"The newly appointed diabetes nurse specialist had completed an audit regarding diabetic care before joining the practice and intended to implement changes at the practice."
Positive
"However there was no one to one formal clinical supervision of the advanced nurse practitioners by the GPs to enhance the support in place."
Positive
"The nursing team were well supported by the nurse manager and had regular monthly team meetings."
Positive
"The nursing team spoke positively regarding the nurse manager."
Positive
"The visits were completed by an advanced nurse practitioner who would liaise with a GP if required."
Positive
"The practice employs six advanced nurse practitioners one nurse practitioner three practice nurses one trainee practice nurse and a nurse manager."
Positive
"This system involved assigning all home visit requests to the advanced nurse practitioner ANP list."
Neutral
"• Advanced nurse practitioners had limited clinical supervision with GPs and did not have one to one peer reviews but did have group training for one hour per fortnight with a GP."
Neutral
"• The practice had recently employed a diabetic nurse specialist."
Neutral
"The team included an inspection manager GP specialist adviser a practice nurse specialist adviser and a practice manager specialist adviser."
2015-03-31 Snippet(s)
Positive
"We saw areas of outstanding practice including: • The practice employed a nurse practitioner to manage and coordinate care for patients in care homes • The practice employed a health care specialist with fitness training to support patients improve their quality of life."
Positive
"Outstanding practice • The practice employed a nurse practitioner to manage and coordinate care for patients in care homes."
Positive
"The practice advanced nurse practitioner undertook weekly ‘ward rounds’ to proactively manage and coordinate care for patients in two care homes under the practice’s care."
Positive
"The nurse practitioner undertook weekly wardrounds for patients in two care homes under the practice’s care to proactively manage and coordinate care."
Positive
"The practice employed an advanced nurse practitioner who visited two local care homes weekly and whom the Are services effective?"
Positive
"For example an advanced nurse practitioner and health care specialists."
Positive
"The nurse practitioner practice nurses and HCAs supported this work which allowed the practice to focus on specific conditions."
Positive
"A nurse practitioner is a clinician who is an advanced practice registered nurse who has completed advanced coursework and clinical education beyond that required of the generalist registered nurse role."
Positive
"The practice manager told us the nurse practitioner also provided guidance on care to staff working at the services."
Positive
"A diabetic specialist nurse held regular clinics at the practice for patients who required additional help with their diabetes."
Neutral
"Bereaved family members were offered the opportunity to speak with the GP or nurse whenever they wanted."
Neutral
"The diabetic specialist nurse held clinics at the practice as patients’ needs required."
Neutral
"For example there was a lead nurse for infection control and the senior partner was the lead for safeguarding."
Latest Snippet(s)
Positive
"However the population group people with long term conditions is rated requires improvement because: • Improvements had been made to the systems for monitoring of patients’ medicines the recall monitoring or treatment of patients with a potential diagnosis of diabetes care planning and the clinical oversight of this work."
Positive
"Improvements had been made to the systems for managing and actioning patient safety alerts ensuring patients prescribed high risk medicines were monitored documenting medicines reviews monitoring or treatment of patients with a potential diagnosis of diabetes care planning and the clinical oversight of this work."
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."
2021-01-29 Snippet(s)
Positive
"We based our judgement of the quality of care at this service on a combination of: • what we found when we inspected • information from our ongoing monitoring of data about services and • information from the provider patients the public and other organisations."
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
"• We found the practice did not have a system in place for recalling monitoring or treating patients with a potential diagnosis of diabetes."
2019-12-06 Snippet(s)
Positive
"We based our judgement of the quality of care at this service on a combination of: • what we found when we inspected • information from our ongoing monitoring of data about services and • information from the provider patients the public and other organisations."
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
"Some staff completed training following the inspection however the process for monitoring the timely completion of training needed to be embedded."
2019-04-26 Snippet(s)
Positive
"We based our judgement of the quality of care at this service on a combination of: • what we found when we inspected • information from our ongoing monitoring of data about services and • information from the provider patients the public and other organisations."
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."
2018-03-12 Snippet(s)
Positive
"• Staff encouraged and supported patients to be involved in monitoring and managing their health."
Positive
"High risk medicines such as methotrexate warfarin and lithium require regular blood monitoring before they are represcribed."
Positive
"Appropriate monitoring was in place for most patients we reviewed."
Positive
"The practice now kept a log of alerts and there was a clear system in place for the management and monitoring of these alerts."
Positive
"The practice kept a log of alerts and there was a clear system in place for the management and monitoring of these alerts."
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 arrangements for planning and monitoring the number and mix of staff needed."
2017-11-07 Snippet(s)
Positive
"For example the management and monitoring of safe prescribing."
Positive
"The practice now kept a log of alerts and there was a clear system in place for the management and monitoring of these alerts."
Positive
"• Reviewed practice documentation in relation to medicines which require monitoring safety alerts which included Medicines & Healthcare products Regulatory Agency MHRA alerts and the system for clinical coding."
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
"• Reviewed the updated policies relating to management of medicines which require monitoring MHRA alerts and coding."
2017-08-10 Snippet(s)
Positive
"Monitoring risks to patients There were limited procedures for assessing monitoring and managing risks to patient and staff safety."
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 was no an effective system in place for monitoring clinical staff’s immunisation status and no risk assessments had been completed where gaps were identified."
Positive
"The practice utilised healthcare assistants to complete monitoring such as blood pressure waist measurements and weight recording to assist the nurses in the management of long term conditions."
Positive
"• There was no system in place for monitoring whether clinical staff remained on the relevant professional bodies lists."
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
"• On the day of inspection we were not shown evidence of a system in place for monitoring clinicians’ registration status to the relevant professional bodies."
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."
Neutral
"Patient records reviewed showed effective monitoring had taken place for high risk medicines."
Neutral
"However evidence was not provided on the day of inspection of a system in place for monitoring clinicians’ registration status to the relevant professional bodies."
Neutral
"• There were arrangements for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs."
2015-03-31 Snippet(s)
Positive
"Learning and improvement from safety incidents The practice had a system in place for reporting recording and monitoring significant events incidents and accidents."
Positive
"The practice had a system in place for reporting recording and monitoring significant events incidents and accidents."
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."
Latest Snippet(s)
Positive
"• The practice is registered to provide the regulated activities of diagnostic and screening procedures family planning maternity and midwifery services surgical procedures and treatment of disease disorder or injury."
2021-01-29 Snippet(s)
Positive
"• The practice is registered to provide the regulated activities of diagnostic and screening procedures family planning maternity and midwifery services surgical procedures and treatment of disease disorder or injury."
2019-12-06 Snippet(s)
Positive
"• The practice is registered to provide the regulated activities of diagnostic and screening procedures family planning maternity and midwifery services surgical procedures and treatment of disease disorder or injury."
2019-04-26 Snippet(s)
Positive
"• The practice is registered to provide the regulated activities of diagnostic and screening procedures family planning maternity and midwifery services surgical procedures and treatment of disease disorder or injury."
2018-03-12 Snippet(s)
Positive
"• Practice leaders had established proper policies procedures and activities to ensure safety and assured themselves that they were operating as intended or working towards that for example in relation to QOF."
2015-03-31 Snippet(s)
Positive
"Patients were encouraged to participate in health promotion activities such as breast screening cancer testing and smoking cessation."
2021-01-29 Snippet(s)
Positive
"In particular: • We found a lack of clinical leadership capacity and capability to successfully manage challenges and implement and sustain improvements."
Positive
"The practice was rated as inadequate for providing wellled services because: • We found a lack of clinical leadership capacity and oversight to successfully manage challenges and implement and sustain improvements."
2017-08-10 Snippet(s)
Positive
"However there had not been sufficient clinical leadership in place to adequately encourage and embed ongoing improvements."
2021-01-29 Snippet(s)
Positive
"We identified reviews had been coded on the clinical system but there was no evidence in the clinical records of a structured medicine review or consultation with the patient."
2018-03-12 Snippet(s)
Positive
"For example the practice audited all patients on opioids a medicine used for severe pain following a significant event."
Positive
"Appropriate actions had been taken for some patients such as medicine changes and discussions about medicines."
Positive
"• The practice had a medicine review system in place to support patients who take medicines that require monitoring."
Positive
"The practice learned from external safety events as well as patient and medicine safety alerts."
Positive
"Exception reporting is the removal of patients from QOF calculations where for example the patients decline or do not respond to invitations to attend a review of their condition or when a medicine is not appropriate."
2017-11-07 Snippet(s)
Positive
"Appropriate actions had been taken for some patients such as medicine changes and discussions about medicines."
Positive
"• The practice had a medicine review system in place to support patients who take medicines that require monitoring."
Positive
"We found patients affected by this alert had either had a medicine review or had been booked in to see a GP."
2017-08-10 Snippet(s)
Positive
"• The practice had a medicine review system in place to support patients who take medicines that require monitoring."
Positive
"The practice had a medicine review system in place to support patients who take medicines that require monitoring."
2015-03-31 Snippet(s)
Positive
"Medicines management We checked medicines stored in the treatment rooms and medicine refrigerators and found they were stored securely and were only accessible to authorised staff."
Neutral
"There was appropriate emergency medical equipment and medicine available."
2015-03-31 Snippet(s)
Neutral
"We were told by the practice manager and staff confirmed that administrative and receptionist staff rotated roles and all staff were knowledgeable of each other’s roles and were therefore able to stand in for each other in times of absence or busy periods."
Neutral
"Staff told us that if someone wanted to make a complaint the receptionist would see if there was anything they could help with or patients could speak with or see the practice manager."
2018-03-12 Snippet(s)
Neutral
"For example there was a toilet for people who were disabled a hearing loop and a lift to access the first floor."
2018-03-12 Snippet(s)
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."
2017-08-10 Snippet(s)
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."
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."
2015-03-31 Snippet(s)
Positive
"Staff spoke positively about the culture in the practice around clinical audit and quality improvement."
Positive
"The practice was undertaking a clinical audit in the prescribing of anticoagulant medicines anticoagulants are medicines used to reduce the ability of the blood to clot for patients diagnosed with a deep vein thrombosis a thrombosis is the formation of a blood clot within a vein."
Neutral
"The Practice has a system in place for completing clinical audit cycles."
2018-03-12 Snippet(s)
Positive
"This included an induction process onetoone meetings appraisals coaching and mentoring clinical supervision and support for revalidation."
Positive
"There was no one to one clinical supervision on a regular basis for the nursing staff."
Neutral
"• There was scope to formalise the clinical supervision given to nurses."
2017-11-07 Snippet(s)
Positive
"There was no one to one clinical supervision on a regular basis for the nursing staff."
2017-08-10 Snippet(s)
Positive
"• Consider the need to formalise the clinical supervision of the nursing staff from the GPs in order to enhance the support in place."
Positive
"However there was no one to one formal clinical supervision of the advanced nurse practitioners by the GPs to enhance the support in place."
Positive
"However there was limited clinical supervision of the clinical team by the GPs."
Neutral
"• Advanced nurse practitioners had limited clinical supervision with GPs and did not have one to one peer reviews but did have group training for one hour per fortnight with a GP."
Neutral
"However there was scope to formalise the clinical supervision given to nurses."
2018-03-12 Snippet(s)
Positive
"• There were no health and safety risk assessments in place."
Positive
"Actions from the health and safety risk assessment were monitored although not all actions had been completed."
Positive
"The areas where the provider should make improvements are: • Continue to action the recommendations from the health and safety risk assessment."
2017-08-10 Snippet(s)
Positive
"For example there was no health and safety risk assessment in place and no evidence of regular fire drills."
Positive
"There was no health and safety risk assessment in place and regular fire drills had not been undertaken."
Positive
"For example: • There was no health and safety risk assessment in place."
Positive
"In particular: • There was no health and safety risk assessment in place."
Neutral
"• There was no health and safety risk assessment completed to ensure that patients and staff were kept safe."
Neutral
"This covered such topics as safeguarding infection prevention and control fire safety health and safety and confidentiality."
2015-03-31 Snippet(s)
Positive
"The practice manager showed us their risk log which addressed a wide range of potential issues such as health and safety and fire risk assessments legionella and infection control."
2017-08-10 Snippet(s)
Positive
"• The practice had recently employed a palliative care specialist nurse to further improve palliative care."
Positive
"The practice had recently employed a palliative care specialist nurse to further enhance this aspect of care."
Positive
"• The practice had employed a clinical pharmacist to help with the demand of prescription requests and nurses with specialisms in diabetes and palliative care."
Positive
"The practice had recently employed a palliative nurse specialist to further improve the service."
Positive
"• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life."
2015-03-31 Snippet(s)
Positive
"They had a palliative care register and had regular internal as well as multidisciplinary meetings to discuss patient and their families care and support needs."
Positive
"The practice adopted the Gold Standards Framework for the treatment of people nearing the end of their lives and requiring palliative care GSF."
Positive
"The practice adopted the Gold Standards Framework for the treatment of people nearing the end of their lives and requiring palliative care."
Positive
"Working with colleagues and other services The practice held regular palliative care meetings."
Positive
"This was confirmed by the GPs who advised that all patients with palliative care needs were reviewed during these meetings."
Positive
"Information sharing The practice held regular palliative care meetings."
2017-08-10 Snippet(s)
Positive
"The practice had a skill mix of clinicians to meet patient needs however did not yet have strong clinical governance to support this model of care."
2017-08-10 Snippet(s)
Positive
"• The practice nurse was the infection prevention and control IPC clinical lead who liaised with and attended the local infection prevention team meetings to keep up to date with best practice."
Neutral
"This covered such topics as safeguarding infection prevention and control fire safety health and safety and confidentiality."
2017-08-10 Snippet(s)
Positive
"There were good open lines of communication between the IPC lead and the cleaning company."
Neutral
"There were cleaning schedules and monitoring systems in place."
2015-03-31 Snippet(s)
Neutral
"We saw there were cleaning schedules in place and cleaning records were kept."
2015-03-31 Snippet(s)
Neutral
"The practice manager and chair of the PPG produced both a Summer and Winter newsletter for patients registered at the practice."
2015-03-31 Snippet(s)
Positive
"In the notes of the practice’s Significant Event meetings we saw that a medical emergency concerning a patient had been discussed and appropriate learning taken place."
2015-03-31 Snippet(s)
Positive
"The building provides good access with accessible toilets and disabled car parking facilities."
2015-03-31 Snippet(s)
Neutral
"These included telephone consultations internet access for patients who may need to book appointments and request their prescriptions online."
2015-03-31 Snippet(s)
Neutral
"There were toilet facilities for disabled patients and baby changing facilities and access for wheelchair users."
2015-03-31 Snippet(s)
Positive
"They also provided support to meet the needs of the elderly and those patients with long term conditions to improve mobility and manage pain."
Positive
"There was an awareness amongst the staff team that the local population were striving to maintain independent living either alone or with elderly partners."
Neutral
"The practice funded a gym and instructor to meet the needs of their elderly population and improve mobility and pain management."
Neutral
"Care plans had been put in place for elderly patients most at risk of unplanned admissions and regular review meetings were held to assess performance."