What is the Quality of Facilities at Higham Ferrers Surgery

Positive

"The practice also has one practice nurse one advanced nursing practitioner both female."

Positive

"The practice also has one practice nurse one advanced nursing practitioner both female."

Neutral

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

Positive

"The practice could not provide evidence of the specific training for a clinical staff member for immunisation taking samples for the cervical screening programme and for carrying out reviews for people with long term conditions nor could they confirm whether the nurse was safe and competent for the role."

Positive

"• The practice held regular proactive care meetings with the district nurse to refer and review patients’ needs."

Positive

"• Where a patient’s mental capacity to consent to care or treatment was unclear the GP or practice nurse assessed the patient’s capacity and recorded the outcome of the assessment."

Positive

"The practice had a system for production of Patient Specific Directions to enable health care assistants to administer vaccinations after specific training when a doctor or nurse was on 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."

Positive

"We rated the practice good for providing effective caring and responsive services because: • We saw that improvements had been made to the monitoring of patients on highrisk medicines."

Positive

"We based our judgement on 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

"We rated the practice as requires improvement for providing effective caring and responsive because: • Care and treatment was not being effectively delivered due to issues with high risk medicine monitoring and prescribing."

Positive

"Our judgement of the quality of care at this service is based 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."

Positive

"• High risk medicines monitoring was not effective and did not ensure patient safety."

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

"Requires improvement We based our judgement of the quality of care at this service 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."

Neutral

"The assessment of the arrangements in place for planning and monitoring the number and mix of staff needed to match patient needs had not been completed."

Positive

"At the time of our inspection we received assurance that a programme of monitoring and support had been implemented through support from the local clinical commissioning group in response to this matter."

Positive

"• Staff encouraged and supported patients to be involved in monitoring and managing their own health."

Positive

"• The lead GP described the arrangements in place for planning and monitoring the number and mix of staff needed to meet patients’ needs including planning for holidays sickness busy periods and epidemics."

Positive

"• Newly diagnosed patients with diabetes were offered referrals to education and health monitoring programmes to manage their diabetes effectively."

Positive

"However the PPG chair and a former member of the PPG highlighted that communication and engagement with the PPG could be improved especially in learning about areas for improvements implementation plans and monitoring the impact of changes."

Positive

"• The arrangements in place for planning and monitoring the number and mix of staff needed did not reflect patient feedback on the availability of GP appointments available in order to meet demand."

Positive

"The arrangements in place for planning and monitoring the number and mix of staff needed did not reflect patient feedback on the availability of GP appointments available in order to meet demand."

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

"• Arrangements in place for planning and monitoring the number and mix of staff needed to make available adequate number of GP appointments in order to meet demand."

Neutral

"For example the arrangements in place for planning and monitoring the number and mix of staff needed to match patient needs."

Positive

"Management monitoring and improving outcomes for people The practice used the information collected for the Quality and Outcomes Framework QOF and performance against national screening programmes to monitor outcomes for patients."

Positive

"Ongoing monitoring and reporting of concerns ensured routine matters were dealt with swiftly."

Positive

"• A plan to deliver the aims and objectives supported the practice in monitoring achievements."

Positive

"• There were procedures in place for monitoring and managing risks to patient and staff safety."

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

Neutral

"For example we saw evidence of appointment monitoring following feedback about availability of telephone access and appointments."

Positive

"The surgery has good transport links and there is a pharmacy located nearby."

Positive

"The surgery has good transport links and there is a pharmacy located nearby."

Positive

"• Staff were clear on their roles and accountabilities including in respect of safeguarding and infection prevention and control • Practice leaders had established proper policies procedures and activities to ensure safety and assured themselves that they were operating as intended."

Neutral

"It covered such topics as safeguarding infection prevention and control fire safety health and safety and confidentiality."

Positive

"We found that: • Two medicine safety alerts had not been acted upon which put patients at risk."

Positive

"We rated the practice requires improvement for providing safe services because: • We saw that improvements had been made in relation to prescriptions recruitment procedures and medicine safety alerts but other gaps were identified."

Positive

"We rated the practice as requires improvement for providing effective caring and responsive because: • Care and treatment was not being effectively delivered due to issues with high risk medicine monitoring and prescribing."

Positive

"Exception reporting is the removal of patients from the 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

"• The practice acted on and learned from external safety events as well as patient and medicine safety alerts."

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

"• The practice implemented service developments for example the practice was involved in a joint venture with the local acute hospital to employ a clinical pharmacist to help with medicine optimisation."

Positive

"The practice showed us an example whereby an audit of patients treated with a medicine for rheumatoid arthritis and related illness had been prescribed this medicine in accordance with best practice guidelines."

Positive

"In particular we found: • The practice was unable to provide us when asked with a Control Of Substances Hazardous to Health COSHH risk assessment for the use of cleaning products."

Positive

"The practice is registered with the CQC to carry out the following regulated activities diagnostic and screening procedures treatment of disease disorder or injury family planning and treatment of disease disorder or injury."

Neutral

"A registered manager is an individual registered with CQC to manage the regulated activities provided."

Positive

"• Staff were clear on their roles and accountabilities including in respect of safeguarding and infection prevention and control • Practice leaders had established proper policies procedures and activities to ensure safety and assured themselves that they were operating as intended."

Positive

"However the PPG chair and a former member of the PPG highlighted that communication and engagement with the PPG could be improved especially in learning about areas for improvements implementation plans and monitoring the impact of changes."

Neutral

"There was sensor controlled electric doors to the practice with a ramp for wheel chair access."

Positive

"• The practices’ uptake for breast and bowel cancer screening was in line the national average."

Neutral

"• The practice ensured that end of life care was delivered in a coordinated way which took into account the needs of different patients including those who may be vulnerable because of their circumstances."

Positive

"This included an induction process onetoone meetings appraisals coaching and mentoring clinical supervision and support for revalidation."

Positive

"This included ongoing support during clinical sessions onetoone meetings appraisals coaching and mentoring clinical supervision and facilitation and support for revalidating GPs."

Positive

"• Most staff had the skills knowledge and experience to carry out their roles although the practice could not demonstrate oversight of clinical training for all staff."

Positive

"• There were no health and safety risk assessments other than those related to control of substances hazardous to health COSHH fire Legionella Legionella is a term for a particular bacterium which can contaminate water systems in buildings electrical safety and equipment calibration."

Positive

"For example those related to staff recruitment and health and safety needed improvements."

Positive

"However we were not shown other health and safety related risk assessments."

Positive

"• Maintaining a systematic approach to health and safety risk assessments."

Positive

"For example a systematic approach to recruitment determining the skill mix of clinical staff available and health and safety risk assessments was not evident."

Positive

"A systematic approach to health and safety risk assessments was not evident."

Positive

"There was a health and safety policy available with a poster displayed which identified local health and safety representatives."

Neutral

"It covered such topics as safeguarding infection prevention and control fire safety health and safety and confidentiality."

Neutral

"These included patients requiring palliative care carers those at risk of developing a longterm condition and those requiring advice on their diet smoking and alcohol cessation."