What is the Quality of Facilities at Thornbrook Surgery

Positive

"Patients with palliative care needs were reviewed at a monthly multidisciplinary team meeting and had supporting care plans in place."

Neutral

"A rolling four week programme of multidisciplinary meetings were held with representation from a wide range of professionals including district nurses the community psychiatric nurse for older patients social services and the community palliative nurse."

Positive

"The practice also encouraged its patients to attend national screening programmes for bowel and breast cancer screening and uptake was generally in line with local and national averages."

Positive

"The health care assistant or practice nurse would usually act as a chaperone but members of the reception and administration team had undertaken training in support of this role and could also provide this service if Are services safe?"

Positive

"For example a nurse received a CCG award having attended work early on a regular basis to provide treatment for a patient to enable them to get to work and also visited them at home during the weekend."

Positive

"Advanced nurse practitioners and a nurse practitioner complimented the work of the GPs and provided autonomy for these nurses to see patients with a wider range of presentations and to prescribe some medicines directly."

Positive

"For example the advanced nurse practitioners were able to access mentorship and advice from GPs in respect of their roles and particularly in relation to their independent prescribing status."

Positive

"• The practice funded a specialist respiratory nurse who attended the practice once a fortnight to monitor and review patients with breathing difficulties such as those with chronic obstructive airways disease and patients with more complex asthma problems."

Positive

"• Annual reviews for diabetes consisted of coordinated appointments with the health care assistant followed by an appointment with the nurse or GP in one visit to discuss patients’ needs."

Positive

"Care plans had been created for these patients by this nurse and the arrangements in place had impacted on a reduced number of hospital admissions for these patients."

Positive

"The nursing team comprises of two nurse practitioners two practice nurses and two health care assistants."

Positive

"In addition we spoke with representatives from two local care homes a health visitor a district nurse and a member of the CCG medicines management team regarding their experience of working with the practice team."

Positive

"A practice nurse was the appointed infection control lead role and additional training had been undertaken in support of this role."

Positive

"A nurse practitioner triaged calls and ensured that any patient requiring an urgent appointment was seen on the same day."

Neutral

"• The practice funded a specialist respiratory nurse who attended the practice once a fortnight to monitor and review patients with breathing difficulties."

Neutral

"• The practice funded a specialist respiratory nurse to attend the practice each fortnight."

Neutral

"• A community psychiatric nurse CPN worked with the practice and usually attended weekly multidisciplinary meetings to review and discuss any patients with ongoing mental health needs."

Neutral

"A rolling four week programme of multidisciplinary meetings were held with representation from a wide range of professionals including district nurses the community psychiatric nurse for older patients social services and the community palliative nurse."

Neutral

"Staff informed us that patients could book ahead up to two weeks in advance to see a GP and four weeks for a nurse appointment."

Neutral

"The practice manager attended the local practice managers’ meetings and the nurse practitioner had established a network group for others in the area."

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."

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 and mix of staff needed to meet patients’ needs."

Positive

"• Patients had access to a charitable transport service which meant they were able to access cheaper transportation to attend the practice."

Neutral

"• A local charitable service provided transport for the elderly and vulnerable to access surgery appointments."

Neutral

"• A television screen was available in the waiting area displaying information for patients."

Positive

"The practice worked to recognised high quality standards for end of life care to ensure that patient wishes were clear and that they were involved in the planning of their own care."

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."

Positive

"Outcomes for mental health care were above local and national averages."

Positive

"For example a GP attended a CCG clinical governance meeting which highlighted the importance of the six week baby check in ensuring the safety and wellbeing of the child."

Positive

"• A regular programme of clinical audit demonstrated quality improvement and we saw examples of full cycle audits that had led to improvements in patient care and treatment."

Positive

"A regular programme of clinical audit reviewed patient care and ensured actions were implemented to improve services as a result."

Neutral

"• A programme of clinical audit was used to review services and to drive improvements when necessary to enhance outcomes for patients."

Positive

"Monitoring risks to patients and staff • There was a health and safety policy available and there were some risk assessments in place to monitor safety of the premises such as the control of substances hazardous to health."

Positive

"Site inspections were undertaken approximately every six months to check the fabric of the building security issues or other potential health and safety matters."

Neutral

"• The practice had a designated infection control lead who undertook regular audits and worked with the local infection prevention and control teams for advice when required."

Positive

"The practice used a contractor to provide cleaning services at their main site and employed a cleaner for the branch site."

Neutral

"There was a written schedule of cleaning tasks and we saw evidence that these checks were being recorded and arrangements were in place to monitor cleaning standards."

Neutral

"• A local charitable service provided transport for the elderly and vulnerable to access surgery appointments."

Positive

"This included visiting patients at home during the weekend; organising a hospital discharge for a complex patient to comply with a patient’s wishes; and providing a course of treatment outside of opening hours to enable a patient to attend work."