What is the Quality of Care at The Portland Road Practice

Positive

"Patients with mental health problems including those with dementia were supported to make decisions through the use of care plans which they were involved in agreeing."

Positive

"For example those with multiple long term conditions mental health problems including dementia people from vulnerable groups including elderly Are services effective?"

Positive

"We saw examples of such plans for patients with dementia and learning disabilities."

Positive

"The practice regularly screened dementia patients and a recent project undertaken by West London CCG identified only two patients whose diagnosis of dementia had not been appropriately coded."

Positive

"People experiencing poor mental health including people with dementia The practice is rated as good for people experiencing poor mental health including people with dementia."

Neutral

"Patients with a learning disability and mental health problems including those with dementia were supported to make decisions through the use of care plans which they were involved in agreeing."

Positive

"Good practice Our inspection team highlighted the following areas of good practice: The practice was taking part in a dementia research project for which patients at the practice had volunteered."

Positive

"Of those identified for screening we were told a prompt had been placed on their record to invite them for an assessment to detect for possible signs of dementia including a discussion about their memory."

Neutral

"The practice was also taking part in an Imperial College dementia research project for which patients at the practice had volunteered."

Neutral

"They also took part in an Imperial College London dementia research project for which patients at the practice had volunteered."

Neutral

"Examples of long term conditions are diabetes dementia CVD musculoskeletal conditions and COPD this list is not exhaustive."

Positive

"The practice kept a register of patients identified as being at high risk of admission to hospital and of those in various vulnerable groups including patients with learning disabilities and mental health problems."

Positive

"There were a range of protocols to support appropriate medicines management including recall procedures for patients with mental health conditions."

Positive

"We saw for example discussion of a the successful outcome of the management of a patient with mental health and capacity issues where it had been possible to engage with the patient to change their behaviour."

Positive

"Longer appointments were also available for older patients those experiencing poor mental health patients with learning disabilities and those with longterm conditions."

Positive

"Staff responded to patients experiencing a mental health crisis including supporting them to access emergency care and treatment."

Positive

"Patients with mental health problems including those with dementia were supported to make decisions through the use of care plans which they were involved in agreeing."

Positive

"For example staff responded to patients experiencing a mental health crisis including supporting them to access emergency care and treatment."

Positive

"For example those with multiple long term conditions mental health problems including dementia people from vulnerable groups including elderly Are services effective?"

Positive

"People experiencing poor mental health including people with dementia The practice is rated as good for people experiencing poor mental health including people with dementia."

Positive

"Crisis referrals were made for acute mental health issues and the practice was able to facilitate sameday access to psychiatric support."

Positive

"Patients at significant risk were referred to the community mental health services."

Positive

"The practice had an ‘enduring mental illness’ register and for many of these they worked in conjunction with the local mental health team and shared the responsibilities of prescribing."

Neutral

"Patients with a learning disability and mental health problems including those with dementia were supported to make decisions through the use of care plans which they were involved in agreeing."

Positive

"The practice also participated in Local Enhanced Services LES schemes for shared care prescribing mental health prescriptions and blood monitoring."

Positive

"People experiencing poor mental health The arrangements in place to ensure the service was safe were not adequate."

Positive

"Our findings Safe There were arrangements in place to ensure people experiencing poor mental health were kept safe."

Neutral

"The practice had access to the services of a mental health worker and there were regular meetings with multidisciplinary teams to consider the needs of patients in this population group."

Neutral

"However the practice participated in Local Enhanced Services LES schemes regarding mental health prescriptions and related blood monitoring."

Positive

"Where appropriate patients were referred to the local exercise referral scheme which provided supervised exercise sessions for people with a range of conditions including those with or at risk of coronary heart disease diabetes mild to moderate depression and obesity."

Positive

"This may range from depression including post natal depression to severe mental illnesses such as schizophrenia."

Positive

"The practice kept a register of all patients with a learning disability and routinely recalled them to review and check their physical health and wellbeing."

Neutral

"Patients with a learning disability and mental health problems including those with dementia were supported to make decisions through the use of care plans which they were involved in agreeing."

Neutral

"The practice carried out in house spirometry electrocardiogram ECG tests asthma checks and anticoagulation and hypertension monitoring."

Neutral

"For example in administration of vaccines asthma management and medical emergencies."

Positive

"For example we saw discussion of a case of a patient with cancer and another where the capacity of a patient to refuse treatment had been reviewed."

Positive

"The practice also encouraged its patients to attend national screening programmes including bowel cancer and chlamydia screening."

Positive

"Where appropriate patients were referred to the local exercise referral scheme which provided supervised exercise sessions for people with a range of conditions including those with or at risk of coronary heart disease diabetes mild to moderate depression and obesity."

Positive

"This included a free cardiovascular and diabetes risk assessment and advice on how to reduce the risk."

Positive

"Structured annual reviews were undertaken for patients with long term conditions including diabetes COPD and heart failure."

Positive

"The practice also made considerable use of all the available community clinics such as community diabetes respiratory heart failure and the expert patient programmes."

Positive

"Structured annual reviews were also undertaken for patients with long term conditions including diabetes COPD and heart failure."

Positive

"For example a repeat audit of the management of patients with a diagnosis of gestational diabetes mellitus GDM; an audit of patients prescribed anticoagulants and an audit of emergency services attendance in under five year olds."

Positive

"Where appropriate patients were referred to the local exercise referral scheme which provided supervised exercise sessions for people with a range of conditions including those with or at risk of coronary heart disease diabetes mild to moderate depression and obesity."

Neutral

"The practice took part in regular clinical learning set CLS audits relating to long term conditions for example diabetes and musculoskeletal conditions."

Neutral

"For example we reviewed an audit of the management of patients with a diagnosis of gestational diabetes mellitus GDM."

Neutral

"The practice took part in regular clinical learning set CLS audits relating to long term conditions for example diabetes and musculoskeletal conditions."

Neutral

"The practice had taken part in regular CLS audits for example in dermatology diabetes musculoskeletal and nonelective admissions."

Neutral

"These included medication management reviews clinical learning set CLS audits for example on diabetes gastroenterology and urology."

Neutral

"Examples of long term conditions are diabetes dementia CVD musculoskeletal conditions and COPD this list is not exhaustive."

Neutral

"The practice carried out in house spirometry electrocardiogram ECG tests asthma checks and anticoagulation and hypertension monitoring."

Neutral

"For example we saw in practice meeting minutes discussion of a patient who had suffered a stroke who had been visited at home by one of the GPs and had been referred to a range of support services."

Positive

"The practice kept a register of all patients with a learning disability and routinely recalled them to review and check their physical health and wellbeing."

Neutral

"Patients with a learning disability and mental health problems including those with dementia were supported to make decisions through the use of care plans which they were involved in agreeing."

Positive

"The practice offered a full range of immunisations for children travel vaccines and flu vaccinations in line with current national guidance."

Positive

"We saw evidence of calibration checks of relevant equipment for example weighing scales spirometers blood pressure measuring devices nebulisers defibrillator and pulse oximeters."

Positive

"It was practice policy to offer a health check to all new patients registering with the practice which included taking a brief medical history blood pressure height and weight and a urine check."

Neutral

"However the keys were left in one of the vaccine fridges and the room where the fridge was located was left unattended with the door open."

Positive

"The keys were left in both of the practice’s vaccine fridges and during the inspection the room where one of the fridges was located was left unattended with the door open meaning the vaccines were not secure."

Positive

"However the keys were left in both vaccine fridges and during the inspection the room where one of the fridges was located was left unattended with the door open meaning the vaccines were not secure."

Positive

"There were a range of protocols to support appropriate medicines management including recall procedures for patients on anticoagulants and medicines for rheumatoid Are services safe?"