What is the Quality of Facilities at The Ruddington Medical Centre

Neutral

"We spoke with the chair of the PPG."

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

"The practice were signed up to the electronic palliative care coordination system EPaCCS which enables the recording and sharing of people’s care preferences and key details about their care at the end of life."

Positive

"The practice held a register of patients living in vulnerable circumstances including people with a learning disability epilepsy and in need of palliative care."

Neutral

"Multidisciplinary meetings were held every two months to discuss patients on the palliative care register and patients with long term conditions visited by the district nurse Macmillan nurse community matron and chronic obstructive pulmonary disease COPD is a collection of lung diseases team."

Positive

"This was also supported by meeting minutes reviewed which showed the practice discussed care planning arrangements with other professionals such as care home managers the community matron district nurse and Macmillan nurse."

Positive

"Most patients were generally satisfied with the appointment system and confirmed being able to see a doctor and or nurse when needed."

Positive

"We also spoke with a range of practice staff including GPs the nurse practitioner a practice nurse a healthcare assistant the practice manager support services manager and reception staff."

Positive

"The practice staff also liaised with the specialist diabetic nurse in respect of insulin initiation and continual monitoring of diabetic patients."

Positive

"There was also a named nurse responsible for following up patients who did not attend screening."

Positive

"Patients told us they could access urgent appointments or speak to a GP or a nurse when they needed to."

Neutral

"This included the community learning disability team community matron and the Macmillan nurse for patients receiving end of life care."

Neutral

"The clinical team includes two GPs a specialist nurse practitioner two practice nurses and a healthcare assistant."

Neutral

"Meeting minutes reviewed showed monthly multidisciplinary meetings were held with the GPs practice nurse health visitor school nurse and midwife."

Neutral

"Multidisciplinary meetings were held every two months to discuss patients on the palliative care register and patients with long term conditions visited by the district nurse Macmillan nurse community matron and chronic obstructive pulmonary disease COPD is a collection of lung diseases team."

Neutral

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

Positive

"Learning and improvement from safety incidents The practice had a system in place for reporting recording and monitoring significant events."

Positive

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

Positive

"• Ensure systems for assessing monitoring and recording risks and the quality of the service provision are strengthened."

Positive

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

Positive

"The practice staff also liaised with the specialist diabetic nurse in respect of insulin initiation and continual monitoring of diabetic patients."

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 and skill mix of staff needed to meet patients’ needs."

Neutral

"Services for patients were on the ground and first floors and lift access was available."

Positive

"Governance arrangements The practice had a number of policies in place to govern activities and support staff in the carrying out of their duties."

Positive

"The practice had identified the need for clinicians to improve the recording of end of life care decisions using templates within the patient electronic record system."

Positive

"One example included the involvement of an Independent Mental Capacity Advocate IMCA and the community matron in the decision making for end of life care arrangements for a patient."

Neutral

"This included care plans for people with a learning disability receiving end of life care and at risk of hospital admission."

Positive

"Following each clinical audit changes to treatment or care were made where needed."

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

"This included infection control health and safety recruitment and management of unforeseen circumstances emergencies."

Positive

"There was also a health and safety representative but not all staff were aware who they were."

Positive

"There was a health and safety poster displayed for staff reference."

Neutral

"Monitoring safety and responding to risk The practice had a health and safety policy which staff had access to."

Positive

"This was discussed with the infection control lead to ensure improved recording on cleaning schedules."

Neutral

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

Neutral

"However the cleaning schedules had prepopulated ticks for advance dates and gave the impression that cleaning had been done for a future date."

Positive

"Feedback received from two care home managers showed the elderly residents were promptly seen when required and had their care needs and medicines regularly reviewed."

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 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."