What is the Quality of Facilities at The Medici Medical Practice

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 process for monitoring patients’ health in relation to the use of medicines including high risk medicines was in place but not always effective."

Positive

"Patients with mental health problems were seen by GPs only but there was no formal system for monitoring the physical health of patients with severe mental illness."

Positive

"Management monitoring and improving outcomes for people The practice demonstrated an effective general approach to care although had identified some issues with the physical care of patients with mental health problems and diabetes."

Positive

"The intelligent monitoring tool draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality Outcomes Framework QOF and the National Patient Survey."

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

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

Positive

"The practice had recently addressed access issues by piloting the introduction of a telephone triage service and was monitoring the effectiveness of this system."

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 told us about the arrangements for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs."

Positive

"Routine appointments with a GP practice nurse or health care assistant can also be booked through the practice for the Luton Extended Hours Service."

Neutral

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

Neutral

"The clinical team also consists of a nurse practitioner a minor illness nurse two practice nurses two physicians associates a paramedic a pharmacist and two health care assistants."

Positive

"A diabetes specialist nurse also attended the practice to provide advice to staff and support patients whose condition was more complex."

Positive

"The practice had input from the specialist diabetes nurse who attended the surgery and the local psychiatrist for those patients with mental health problems."

Positive

"The practice held multidisciplinary meeting with the MacMillan nurse and district nurse and had a coordinated approach to end of life care."

Neutral

"Staff meetings included attendance by the MacMillan Nurse health visitor and district nurse."

Neutral

"For example the practice manager was the lead nurse for infection control and the senior partner was the lead for safeguarding."

Positive

"We rated the practice as requires improvement for providing safe services because: • The systems in place for the appropriate and safe use of medicine were not always sufficient or followed."

Positive

"We saw evidence to confirm that after receiving an alert the GPs had reviewed the use of the medicine in question and where they continued to prescribe it outlined the reason why they decided this was necessary."

Neutral

"Medicines management During our inspection we checked how medicines were stored in the treatment rooms and medicine refrigerators."

Positive

"The PPG chair reported that the practice had been responsive to the views of the group and had listened and worked with them to improve services."

Positive

"Prior to our inspection we spoke with the chair of the patient participation group who shared the views of the group regarding the engagement of the practice with them."

Positive

"The PPG chair also told us that the practice provided a demonstration of the new SystmOne clinical system as the PPG had expressed concerns regarding transfer of information."

Positive

"These meetings were attended by district nurses palliative care nurses and decisions about care planning were documented in a shared care record."

Positive

"It had a palliative care register and had regular internal as well as multidisciplinary meetings to discuss the care and support needs of patients and their families."

Positive

"We saw that the practice kept a list of vulnerable patients for example those with learning disabilities and those requiring palliative care so they were able to identify those patients immediately to ensure they addressed any issues or unmet needs."

Neutral

"There was a lift to the first floor where consultations also took place and there were disabled toilets and toilets with baby changing facilities."

Positive

"The entrance to the premises and services had been adapted to meet the needs of patient with disabilities with an approaching ramp for wheelchair access and wide opening automatic doors and a large reception and waiting area allowing easy access for wheelchairs and prams."

Neutral

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

Neutral

"The practice showed us one clinical audit that had been undertaken in the last year by the trainee doctors regarding ACE inhibitors but did not demonstrate that it had been reviewed therefore was not complete."

Neutral

"The team was making use of clinical audit tools clinical supervision and staff meetings to assess the performance of clinical staff."

Neutral

"The team was making use of clinical audit tools clinical supervision and staff meetings to assess the performance of clinical staff."

Positive

"Health and safety information was displayed for staff to see and there was an identified health and safety representative."

Positive

"The practice also had a health and safety policy."

Positive

"• Ensure that all staff receive infection control update training • Ensure that infection control cleaning schedules and audit is updated and completed as planned."

Positive

"For example we saw evidence of only one audit and whilst we were told there was a cleaning schedule being developed this was work in progress and not being completed at the time of the inspection."

Positive

"• The practice should ensure that infection control cleaning schedules and audit is updated and completed as planned."

Neutral

"They also provided us with a cleaning schedule had been in use following the day of inspection."