What is the Quality of Facilities at Loughton Health Centre

Neutral

"The team included a GP specialist adviser and a nurse practitioner specialist adviser."

Neutral

"The team included a GP specialist adviser and a practice nurse specialist adviser."

Neutral

"The team included a GP specialist adviser and a practice nurse specialist adviser."

Neutral

"The ‘hub’ was a GP provider company offering GP and nurse appointments out of usual practice hours."

Neutral

"There was an appointment with the nurse available the day after our inspection."

Neutral

"This was evidenced by the nurse forum meetings and the discussions with a neighbouring practice concerning a possible change to information systems."

Positive

"The nurse saw patients with learning disabilities before their annual review to undertake blood pressure height and weight checks before their appointment with the GP."

Positive

"They told us that they were satisfied with the GP the nurse and other staff working at the practice."

Positive

"We spoke with a nurse and a healthcare assistant responsible for this room who discussed with us the efforts they made to maintain this room as hygienically as possible."

Positive

"Appointments were available with the nurse for cervical smear testing childhood vaccinations and travel immunisations during normal surgery hours."

Neutral

"A clinic for those with diabetes ran twice each month with a nurse qualified in diabetes management and one of the GPs in attendance."

Positive

"We based our judgement of the quality of care at this service is on a combination of: • what we found when we inspected • information from our ongoing monitoring of data about services and • information from the provider patients the public and other organisations."

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

"• The practice had implemented a system of search and audit to identify and recall patients who required additional monitoring or those who needed to be reviewed as a result of NICE guidance or safety alerts."

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

"This includes monitoring patients on longterm medicines reviews of longterm health conditions and the lack of quality improvement activity."

Positive

"• Whilst the practice focused on meeting the immediate needs of patients longer term monitoring and review was overlooked."

Positive

"Inspectors identified risks to patient safety which included managing MHRA alerts adherence to current prescribing guidelines and monitoring patients who were prescribed highrisk medicines."

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

"• The practice was not monitoring prescription stationery as it was distributed in the practice."

Neutral

"There was limited measurement and monitoring of safety performance."

Neutral

"• There were arrangements for planning and monitoring the number and mix of staff needed."

Neutral

"• The practice kept prescription stationery securely although they were not monitoring this as it was distributed in the practice."

Neutral

"• The practice did not identify and recall patients who were prescribed medicines that require additional monitoring or record if this was done elsewhere for example in hospital."

Neutral

"This includes monitoring patients on longterm medicines reviews of longterm health."

Positive

"This supported the needs of patients who were able to receive appropriate monitoring along with advice and guidance as to how best to manage their condition and maintain a healthy lifestyle."

Positive

"Management monitoring and improving outcomes for people The practice monitored their performance using the Quality and Outcomes Framework QOF."

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 lead safeguarding GP was aware of those patients identified as vulnerable and was monitoring and reviewing them."

Positive

"The practice was taking steps to improve their monitoring of patients with diabetes."

Positive

"They had noticed an increase in their antibiotic prescribing and were monitoring it."

Positive

"They were monitoring their performance and felt that they had reached those patients most vulnerable."

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 across the practice were involved in monitoring outcomes for patients."

Neutral

"Data available from QOF reflected that the practice was monitoring patients with these illnesses effectively."

Neutral

"In relation to patients with diabetes the practice was aware that their monitoring and review processes were below the national average."

Neutral

"Some audits we viewed included a prescribing audit for a particular medicine the monitoring of patients with osteoporosis A & E attendance and appointment availability."

Positive

"• Practice leaders had reviewed and updated policies procedures and activities to ensure safety and assure themselves that they were operating as intended."

Positive

"There was no health and safety risk assessment."

Positive

"There was a comprehensive health and safety risk assessment and staff had received health and safety training."

Positive

"Staff had not received health and safety training."

Neutral

"• There was an up to date health and safety risk assessment and staff had now received health and safety training."

Positive

"• The health and safety risk assessment to consider possible risks at the premises had not been completed."

Positive

"There was no health and safety risk assessment."

Positive

"• There was no health and safety risk assessment."

Positive

"Staff had not received health and safety training."

Positive

"• Staff had not received health and safety training."

Positive

"Other risks had not been identified in respect of health and safety and professional competence of clinical staff for example."

Positive

"• The practice did not have effective systems to identify that staff had not received health and safety infection control or safeguarding vulnerable adults training."

Positive

"A health and safety risk assessment had taken place that identified the risks to both patients and staff."

Positive

"There were leads for infection control safeguarding diabetes minor procedures health and safety and information governance."

Positive

"Lessons learned and improvements made • The practice had implemented effective systems to ensure that they acted on patient and medicine safety alerts and changes to NICE guidelines."

Positive

"The practice had not carried out a risk assessment to identify medicines that it should stock and did not stock atropine a medicine that is used in the event of an adverse reaction to coil insertion."

Positive

"Exception reporting is the removal of patients from QOF calculations where for example the patients decline or do not respond to invitations to attend a review of their condition or when a medicine is not appropriate."

Positive

"Gabapentin is a medicine to prevent and control seizures."

Positive

"Amlodipine is a medicine used to reduce high blood pressure."

Positive

"This involved identifying patients on medicines where a risk had been identified then reviewing the need for the medicine and then changing it if required after discussing it with the patient."

Positive

"Medicines management We looked at how medicines were stored in the medicine fridges and found they were stored securely and were only accessible to authorised staff."

Positive

"Where issues had been discovered timely repairs had taken place Other systems were in place to monitor risk including medicine reviews for patients handling national patient safety and medicines alerts dealing with emergencies and the servicing maintenance and calibration of medical equipment."

Neutral

"Some audits we viewed included a prescribing audit for a particular medicine the monitoring of patients with osteoporosis A & E attendance and appointment availability."

Positive

"• Following our inspection the practice updated their palliative care handover form and implemented systems to readcode relevant patients so that information could be more effectively shared with other healthcare professionals."

Positive

"The practice had a register of patients with palliative care needs and monthly multidisciplinary meetings took place where the care and treatment of individual patients was monitored and discussed."

Positive

"These meetings were attended by a variety of other healthcare professionals including district nurses social workers and palliative care nurses."

Positive

"A lower reception desk could be made available to promote effective communication for patients who used a wheelchair and a consulting room had been specially adapted to accommodate patients who used wheelchairs."

Positive

"The practice is accessible by public transport bus and train."

Positive

"The practice is accessible by public transport bus and train."

Neutral

"The practice held multidisciplinary team meetings monthly for those patients with longterm conditions end of life care needs or children on the at risk register."

Positive

"Staff had received specialist training in respiratory care and diabetes management."

Positive

"The checklist covered cleaning surfaces between patients and a monthly deep clean."

Positive

"The room allocated for minor surgical procedures had a robust cleaning procedure in place due to the increased risk of infection from invasive procedures."

Neutral

"We saw that cleaning schedules were in place that identified the type of cleaning required and the frequency."

Neutral

"Checklists had been completed by staff on a daily basis that reflected cleaning was being undertaken."

Neutral

"Records had been kept to display that the cleaning schedules had been complied with and they had been dated and initialled as completed."

Positive

"Staff were trained in safeguarding procedures in relation to the elderly and vulnerable and knew the different signs of abuse."

Positive

"Flu vaccinations were available for elderly patients or those with conditions that made them vulnerable to the virus."

Positive

"Patients who were elderly and vulnerable those with longterm conditions or with complex issues were identified and recorded on a register."