What is the Quality of Facilities at Woodbridge Practice

Positive

"There is one nurse practitioner five practice nurses and two health care assistant."

Positive

"For example a nurse had been appointed as the infection and prevention control lead and had received no further training or clarity of this job role."

Neutral

"The GP and practice nurse also accommodated home visits for those who had difficulties getting to the practice."

Positive

"The practice had increased the number nurse practitioners up to six to support GPs and improve access to appointments."

Positive

"This initiative would help to promote the role of the nurse practitioner."

Positive

"These patients also commented about the attitude of some staff and being unhappy with seeing the nurse practitioner for an appointment."

Positive

"They are supported by six nurse practitioners all female and a practice nurse team which includes four registered nurses and two healthcare assistants HCA all female."

Positive

"We saw that some patients were unhappy to see a nurse practitioner."

Positive

"We were told that practice meetings were still taking place however there were no recent minutes of meetings with the exception of the regular nurse Are services effective?"

Positive

"This initiative promoted the role of the nurse practitioner."

Neutral

"The practice employs nurse practitioners who have been trained to review and treat patients."

Neutral

"During our inspection we spoke with four GPs two nurse practitioners one HCA the practice manager and assistant manager and five administration staff."

Neutral

"The GPs and nurse practitioners told us they meet at a set time each day to discuss any concerns relating to patients and seek advice from other clinicians."

Neutral

"Following the audit the GPs and nurse practitioners reviewed their prescribing trends."

Neutral

"Patients could also pre book appointments with the GP nurse or HCA."

Neutral

"For example there was a lead GP and nurse for infection control and another GP was the lead for safeguarding."

Neutral

"An example of these were the minutes from the nurse meetings."

Neutral

"The PPG had also received a presentation from the nurse practitioner about the different roles of clinicians and who patients should see."

Neutral

"We saw that the practice had addressed this with training for staff in answering the telephone increasing the number of phone lines and employing more GPs and nurse practitioners."

Positive

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

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 for planning and monitoring the number and mix of staff needed."

Positive

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

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."

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."

Neutral

"The practice had a process in place for making referrals and monitoring this process."

Positive

"The practice 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

"Medicines management We checked medicines stored in the practice and medicine refrigerators and found the majority 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."

Neutral

"These included reproductive medicine diplomas in children’s health and obstetrics."

Positive

"However palliative care meetings were not being minuted."

Positive

"These meetings were attended when appropriate by district nurses and palliative care nurses so decisions about care planning were agreed and documented in shared care records."

Positive

"It had a palliative care register."

Positive

"• Leaders had established some policies procedures and activities to ensure safety but had not assured themselves that they were operating as intended."

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."

Neutral

"• There was a system to manage infection prevention and control however further action was needed."

Neutral

"There was lift access to the first floor."

Neutral

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

Neutral

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

Positive

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

Positive

"The carpets and chairs were clean and staff were aware of what action to take if cleaning was required however we did not see a schedule for regular cleaning or a process for addressing stains."

Neutral

"We saw there were cleaning schedules in place and cleaning records were kept The practice had a 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."