What is the Quality of Facilities at The Homewell Practice

Positive

"Older people: • The telephone hub based in the practice was supported by a nurse practitioner throughout the day which allowed for local care and nursing homes to have direct contact with a clinician during the practice’s opening hours."

Positive

"The hub offered advice to nonurgent queries arranged appointments and was supported by a nurse practitioner daily."

Positive

"One of the practice’s nurse practitioners was the practice’s designated longterm conditions lead and was responsible for undertaking the annual reviews of all patients with longterm conditions."

Positive

"During the practice’s opening hours patients could request advice or information from nonclinical staff who were supported by a nurse practitioner every day."

Positive

"There are four advanced nurse practitioners one of whom is also a partner in the practice one nurse practitioner two practice nurses two assistant practitioners and four healthcare assistants."

Neutral

"The practice had a designated lead practice nurse who oversaw the infection prevention and control responsibilities for the whole practice."

Positive

"Monthly multidisciplinary meetings including district nurses the palliative care nurse and care coordinators took place."

Positive

"Supporting the GPs are one Nurse who is also a partner in the practice three nurse practitioners two practice nurses and five health care assistants."

Positive

"We discussed with the practice manager GP and nurse how NICE guidance was received into the practice."

Positive

"Patients were triaged by a nurse practitioner for the most appropriate appointment for their needs."

Positive

"A practice nurse had responsibility for following up patients who did not attend."

Positive

"They confirmed that they could see a doctor or nurse on the same day if they felt their need was urgent although this might not be their GP of choice."

Neutral

"They also told us they had enough time with the GP or nurse to discuss their concerns."

Neutral

"This same day service is a nurse practitioner led clinic."

Neutral

"For example there was a lead nurse for infection control and there was a lead for safeguarding."

Positive

"• Staff encouraged and supported patients to be involved in monitoring and managing their own health for example through social prescribing schemes."

Positive

"• Arrangements were in place for planning and monitoring the number and mix of staff needed to meet patients’ needs including planning for holidays sickness busy periods and epidemics."

Positive

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

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

"Management monitoring and improving outcomes for people Information about people’s care and treatment and their outcomes was routinely collected and monitored and this information used to improve care."

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

"Staff across the practice had key roles in monitoring and improving outcomes for patients."

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

"Staff told us about the arrangements for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs."

Positive

"A Registered Manager is an appropriate person that is responsible for the regulated activities of a practice to ensure patients have their health needs met."

Positive

"• Practice leaders reported they had established policies procedures and activities to ensure safety and assured themselves that they were operating as intended."

Positive

"Curlew Practice is registered with the Care Quality Commission to provide regulated activities for the treatment of disease disorder or injury diagnostic and screening procedures maternity and midwifery services surgical procedures and family planning."

Positive

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

Positive

"The clinical team also accommodated home visits for those who had difficulties getting to the practice due to limited local public transport availability."

Positive

"The clinical team also accommodated home visits for those who had difficulties getting to the practice due to limited local public transport availability."

Positive

"For example those with multiple long term conditions mental health problems people from vulnerable groups those with end of life care needs or children on the at risk register."

Neutral

"This included one to one meetings appraisals coaching and mentoring clinical supervision and revalidation."

Neutral

"• The dementia diagnosis rate was comparable to the national average The team was making use of clinical audit tools clinical supervision and staff meetings to assess the performance of clinical staff."

Positive

"• The practice was not able to provide evidence of comprehensive risk assessments in relation to fire health and safety and premises security as these were completed and retained by NHS Property Services who owned the building."

Neutral

"• However the practice did not have full oversight of all health and safety issues including security within the building."

Neutral

"• The practice could not provide adequate assurances that all risk assessments including health and safety and premises security for the practice were in place."

Positive

"Health and safety information was displayed for staff to see and there was an identified health and safety representative."

Positive

"The practice also had a health and safety policy."

Neutral

"The practice had a designated lead practice nurse who oversaw the infection prevention and control responsibilities for the whole practice."

Positive

"• The practice acted on and learned from external safety events as well as patient and medicine safety alerts."

Positive

"Medicines management We checked medicines stored in medicine refrigerators and found they were stored securely and were only accessible to authorised staff."

Positive

"We saw evidence that after receiving an alert the GPs had reviewed the use of the medicine in question and where they continued to prescribe it outlined the reason why they decided this was necessary."

Neutral

"We saw one example where a new patient had been given a different medicine to their usual one because it had a similar sounding name."

Positive

"GPs we spoke with told us patients would benefit from the merger as there would be better access to care including palliative care and also the same day clinic."

Positive

"These meetings were attended by district nurses social workers palliative care nurses and an oncology team and decisions about care planning were documented in a shared care record."

Positive

"The practice also maintained a gold standards framework GSF register for palliative care patients and monthly MDT meetings with the integrated care team and external organisations."

Positive

"It had a palliative care register and had regular internal as well as monthly multidisciplinary meetings to discuss and plan the care and support needs of patients and their families."

Positive

"Monthly multidisciplinary meetings including district nurses the palliative care nurse and care coordinators took place."

Positive

"The surgery had wide doors to allow for wheelchair access and there was good access to all of the consultation rooms."

Neutral

"The CCG had developed a local commissioned service aimed at clinical governance in general practice."

Neutral

"• The dementia diagnosis rate was comparable to the national average The team was making use of clinical audit tools clinical supervision and staff meetings to assess the performance of clinical staff."

Neutral

"We saw there were cleaning schedules in place and cleaning records were kept."