What is the Quality of Facilities at Greenford Avenue Family Health Practice

Positive

"These meetings were attended by district nurses health visitors the palliative care team and community matron and decisions about care planning were documented in a shared care record."

Positive

"The practice had a palliative care register and had regular multidisciplinary meetings to discuss the care and support needs of these patients and their families."

Positive

"The practice held regular multidisciplinary team meetings attended by district nurses the community matron and palliative care team to discuss and manage the care plans of patients with complex needs."

Positive

"There were regular multidisciplinary team meetings with district nurses community matrons and palliative care teams to discuss and meet the needs of frail elderly patients."

Positive

"The practice held regular multidisciplinary team meetings with district nurse community matron and the palliative care team to discuss and manage the needs of patients with long term conditions."

Positive

"The practice maintained a list of patients receiving palliative care and this was available to the out of hour’s provider."

Positive

"The practice had close links with the palliative care nursing team and held quarterly meetings with them."

Positive

"The nurse practitioner was the Caldicott Guardian senior person responsible for protecting confidentiality of patients for the practice and also the lead for the anticoagulation service and we saw training records to confirm they had appropriate training to fulfil these roles."

Positive

"The practice held regular multidisciplinary team meetings with district nurse community matron and the palliative care team to discuss and manage the needs of patients with long term conditions."

Positive

"The practice team comprises one male GP partner one male and one female salaried GP one female nurse practitionerclinical governance manager one female practice nurse and one female medical assistant who undertook health care assistant duties but had trained as a doctor in their native homeland."

Neutral

"The practice offered GP and nurse domiciliary review of housebound patients."

Neutral

"The practice nurse had a procedure for following up on children who had not attended appointments for childhood immunisations that involved sending regular letter invitations every eight weeks."

Neutral

"The nurse practitioner was the lead for the anticoagulation service and used an international normalized ratio INR software programme to measure and manage INR levels for patients taking warfarin."

Neutral

"All prescriptions were reviewed and signed by a GP before they were given to the patient with the exception of those prescribed by the nurse practitioner who was trained as an independent prescriber."

Neutral

"The nurse practitioner was the lead for infection control and had undertaken further training to enable them to provide advice on the practice infection control policy."

Neutral

"The practice nurse also attended a twice monthly network MDT with other local practices and GPs to discuss complex cases and case reviews with an education component so that clinicians could learn from each other’s experiences."

Neutral

"It was practice policy to offer a health check with the practice nurse to all new patients registering with the practice."

Neutral

"The practice nurse coordinated follow up of patients who did not respond to invites for smears and childhood immunisations and letter reminders were sent or phone calls made every eight weeks for those due invitations."

Neutral

"One of the administration team also maintained a list of patient’s overdue smears as a failsafe and would update the practice nurse with any changes."

Neutral

"The practice also offered nurse led domiciliary assessments that included taking blood for warfarin monitoring for housebound patients."

Neutral

"The practice offered nurse led annual review of patients with longterm conditions."

Neutral

"The practice nurse had a procedure to follow up on patients who had not attended their immunisation appointments."

Neutral

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

Positive

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

Positive

"The practice holds a core General Medical Services GMS contract and is commissioned for the provision of local enhanced services which include extended hours minor surgery and International Normalised Ratio INR monitoring used to monitor the effectiveness of the anticoagulant warfarin."

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 number of policies and procedures to govern activity and held regular governance meetings to discuss performance monitoring significant events and training."

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 was a system in place for the management of highrisk medicines such as warfarin which included regular monitoring in line with national guidance."

Neutral

"Staff told us the arrangements for planning and monitoring the number and mix of staff were currently under review."

Neutral

"The practice also offered nurse led domiciliary assessments that included taking blood for warfarin monitoring for housebound patients."

Positive

"The premises were spread over two floors there was no lift access to the upstairs rooms but we were told that staff would move to one of the rooms downstairs if they were seeing a patient who could not manage the stairs."

Positive

"We noted the doorbell for this rear door was not an appropriate height for wheelchair users."

Positive

"There was wheelchair access to the practice site via a rear door as the main entrance was not wheelchair accessible."

Neutral

"The practice held quarterly multidisciplinary team meetings MDT to discuss the needs of complex patients for example those with end of life care needs or children on the at risk register."

Positive

"This included a clinical governance policy that included guidance on patient involvement clinical audit evidence based management staff feedback risk control and continuing professional development."

Positive

"This included a clinical governance policy that included guidance on patient involvement clinical audit evidence based management staff feedback risk control and continuing professional development."

Neutral

"We were shown several examples of clinical audit in first cycle stage that were due to be reviewed and completed in the next four months."

Neutral

"Staff we spoke with told us clinical audit was mostly GP led."

Neutral

"The GPs were aware of their responsibilities in performing clinical audit to drive improvements to practice and professional development."

Positive

"The practice also had a health and safety policy that included fire safety hazardous waste disposal premises maintenance equipment maintenance medicine storage and personal safety and dealing with aggression."

Positive

"Health and safety information was displayed for staff to see and the administrative lead was the practice health and safety representative."

Neutral

"We saw there were cleaning schedules in place that included daily weekly and monthly cleaning tasks and cleaning records were kept."

Neutral

"We saw for example that an update about the use of spill packs for the cleaning of body spillage had been presented at a recent practice meeting."

Positive

"There were regular multidisciplinary team meetings with district nurses community matrons and palliative care teams to discuss and meet the needs of frail elderly patients."

Positive

"We saw evidence that care plans had been completed for elderly patients with complex needs."

Positive

"The practice also had a health and safety policy that included fire safety hazardous waste disposal premises maintenance equipment maintenance medicine storage and personal safety and dealing with aggression."

Positive

"For example we saw audits were in progress on anticoagulation prescriptions in patients at high risk of stroke and prescribing in patients at risk of osteoporosis as part of the medicine management incentive scheme."

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."

Positive

"We saw an example to confirm that after receiving an alert from the Medicines and Healthcare Products Regulatory Agency MHRA about an antisickness medicine the GPs had reviewed the use of the medicine in their patient population."

Neutral

"We were told the GPs were performing regular medicine reviews for patients with polypharmacy prescribed multiple medicines."