What is the Quality of Facilities at The Portland Road Practice

Positive

"The practice also employed four salaried GPs a practice nurse covered by a locum nurse a health care assistant and seven administrative staff."

Positive

"To meet the needs of this population the practice ran dedicated nurse and baby clinics and a health visitor led dropin clinic on Thursday afternoons."

Neutral

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

Neutral

"The majority of staff had received refresher training within the last year although evidence of this was not available for the locum nurse employed at the time of the inspection."

Neutral

"The locum nurse employed at the time of the inspection was taking specific action to see patients in areas where targets needed improvements."

Neutral

"Patients with repeat prescriptions were asked to see a doctor or nurse for a medication review six monthly or at annual intervals to decide whether they should continue their medication."

Positive

"The practice also employed three salaried GPs a practice nurse a health care assistant and six administrative staff."

Positive

"The practice nurse carried out a weekly check of drugs in the practice’s two emergency resuscitation kits."

Positive

"Patients were invited for routine monitoring throughout the year according to Nice Guidance and to achieve QOF targets."

Positive

"There were governance arrangements in place through which risk and performance monitoring took place and service improvements were identified."

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

"There was a system in place for the management of high risk medicines which included regular monitoring in line with national guidance."

Positive

"Management monitoring and improving outcomes for people The practice had a system in place for completing clinical audit cycles."

Positive

"These included participation in direct enhanced schemes DES for remote care monitoring minor surgery influenza and pneumococcal immunisations and childhood vaccination and immunisation scheme."

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 in place for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs."

Positive

"The practice participated in Directed Enhanced Service DES schemes to provide annual health checks for patients with learning disabilities working with the local community learning disabilities team and an anticoagulant monitoring service for other practices."

Positive

"The regulations were not being met in relation to assessing and monitoring the quality of service provision."

Positive

"The provider had a number of arrangements in place for monitoring safety and responding to risk related to the operation of the premises."

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

"Incidents were also reported to the CCG for monitoring purposes."

Positive

"• The practice provided appropriate support for end of life care and patients and their carers received good emotional support."

Positive

"The practice provided appropriate support for end of life care and patients and their carers received good emotional support."

Positive

"The practice took a proactive approach to end of life care and also provided direct bereavement support by calling patients in or by visiting them."

Positive

"The practice was also proactive in supporting patients in their choice of end of life care planning and used the ‘Coordinate My Care’ CMC website to notify other agencies such as the London Ambulance Service and out of hours providers of these wishes."

Positive

"There were leaflets in the reception area to signpost patients receiving end of life care their families and loved ones or the recently bereaved to sources of support."

Positive

"The practice held monthly multidisciplinary team meetings to discuss patients with complex needs including elderly and frail patients and those with end of life care needs."

Positive

"There were appropriate and effective end of life care arrangements in place."

Positive

"There were leaflets in the reception area to signpost patients receiving end of life care their families and loved ones or the recently bereaved to sources of support."

Positive

"Individual patient care planning and treatment was also discussed including end of life care and all patient referrals and hospital discharges were reviewed."

Positive

"They were receptive to the idea of appointing a group member as an independent chair and to spend time at the practice to encourage joiningparticipating in the PPG which had been raised by the practice as a result of feedback at the inspection."

Positive

"These meetings were attended by district nurses health visitors midwives social workers palliative care nurses and the community matron."

Positive

"Doctors had links with bereavement counsellors and worked closely with the local palliative care team."

Positive

"Details of patients on palliative care were faxed directly to the duty doctor."

Positive

"Doctors had links with bereavement counsellors and worked closely with the local palliative care team."

Positive

"These activities were logged in the named fire marshal’s handbook."

Neutral

"The reception desk had low access for wheelchair users and a hearing loop."

Neutral

"The reception desk had low access for wheelchair users and a hearing loop."

Positive

"The practice participated in clinical audit and routinely collected information to review and improve patient care and outcomes."

Positive

"Management monitoring and improving outcomes for people The practice had a system in place for completing clinical audit cycles."

Positive

"The practice also had a health and safety policy and health and safety information was displayed for staff to see."

Positive

"The practice had a number of policies and procedures in place to ensure safe patient care such as health and safety infection control and dealing with significant events."

Positive

"The practice’s health and safety risk assessment had also not been communicated to staff."

Neutral

"It was not clear how recommended controls identified from the practice’s health and safety risk assessment were communicated within the practice and followed up and implemented."

Positive

"Cleanliness and infection control risk assessments had been completed and we saw from the minutes of practice meetings cleaning standards and infection control were regularly reviewed."

Positive

"We saw evidence that the cleaning contract had been reviewed and increased from four to six hours per day."

Neutral

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

Neutral

"Minutes of practice meetings showed that cleaning and infection control were discussed regularly."

Positive

"Cleanliness & Infection Control The practice had a cleaning contract an infection control policy named staff responsible for infection control the provision of personal protective equipment and a waste management contract."

Positive

"For example regular washing of children’s toys with disinfectant was recommended but this was not included on the cleaning schedule and there was no record that the cleaning was carried out."

Neutral

"For example it did not include the cleaning of children’s toys facilities in the baby changing room or blinds."

Positive

"The practice had also been part of a pilot scheme that supported an MDT approach in nursing and care homes which involved a doctor attending monthly ward rounds with a pharmacist social worker and elderly care consultant."

Positive

"Visits were made monthly to a local care home which involved a doctor attending ward rounds with a pharmacist social worker and elderly care consultant."

Positive

"The practice held monthly multidisciplinary team meetings to discuss patients with complex needs including elderly and frail patients and those with end of life care needs."

Positive

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

Positive

"In the last year the practice had completed an audit of prescribing of high risk anticoagulation medicine and had taken follow up action based on the outcomes."

Neutral

"We checked medicines stored in the treatment rooms and medicine refrigerators."

Neutral

"There were individual job descriptions for each post and named leads for specific areas including clinical governance safeguarding prescribing and infection control."

Positive

"We saw from the practice manager’s weekly meetings log that referrals and hospital discharge summaries for each week were reviewed by the clinical team although it was not clear from the log how the reviews were followed up."