What is the Quality of Facilities at Dr. McCarthy and Partners

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

"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

"Monitoring risks to patients There were procedures for assessing 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 a system for monitoring repeat prescribing for patients receiving medicines for mental health needs."

Neutral

"• There were arrangements for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs."

Positive

"Management monitoring and improving outcomes for people Care plans were in place for patients with complex or multiple health conditions."

Positive

"Governance arrangements We saw systems in place for monitoring all aspects of the service such as complaints incidents safeguarding risk management clinical audit and infection control."

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 clinical team includes an advanced nurse practitioner ANP a senior clinical pharmacist two advanced nurse practitioners a senior practice nurse two practice nurses and a healthcare assistant."

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

"This enabled clinical staff to monitor and review patients and to utilise staff with the most appropriate clinical skillset to meet these needs for example GPs nursing team clinical pharmacist or nurse practitioners."

Positive

"Practice management meetings were held monthly and nurse meeting were in general held every month which provided an opportunity for these staff to learn about the performance of the practice."

Positive

"The clinical team includes an advanced nurse practitioner ANP a senior pharmacy practitioner a nurse practitioner a senior practice nurse three practice nurses and a healthcare assistant."

Positive

"• The advanced nurse practitioner could prescribe medicines for clinical conditions within their expertise as they received additional training and were qualified to do so."

Neutral

"The nurses clinical pharmacist and nurse practitioner reviewed patients in specialised clinics."

Neutral

"The senior practice nurse and nursing staff had completed level two training."

Neutral

"• The senior practice nurse was the infection prevention and control IPC clinical lead."

Neutral

"• Increase patient awareness that nurse appointments for chronic disease clinics could be arranged via the nurse administrator."

Positive

"We were assured that the necessary audit and paperwork would be undertaken by the lead nurse at the earliest opportunity and this would be forwarded to the CQC."

Neutral

"The practice manager informed us that the lead nurse would hold the IPC audit information and was not available on the day of the inspection."

Neutral

"For example the nurse actively screened patients for diabetes and monitored their long term conditions."

Neutral

"GPs were revalidated and nurse professional registrations were up to date and checked on an annual basis."

Neutral

"Our key findings were as follows: • Staff who provided a chaperone service had been in receipt of chaperone training and been subject to disclosure and barring service DBS checks."

Neutral

"All the GPs had disclosure and barring service DBS checks undertaken by NHS England as part of their appraisal and revalidation process."

Positive

"• Looked at information the practice used to deliver care and treatment such as patient medicine safety alerts."

Positive

"• All staff received annual basic life support training and there were emergency medicines available in the treatment room with the exception of a medicine used in cases such as cervical shock following insertion of a contraceptive coil."

Positive

"For example a patient had been prescribed a disease modifying medicine in secondary care."

Positive

"Clinical exception rates allow practices not to be penalised where for example patients do not attend for a review or where a medicine cannot be prescribed due to side effects."

Neutral

"This medicine had not been codedrecorded in the patient’s record and one of the GPs had prescribed an antibiotic medicine that had the potential to interact with this medicine."

Positive

"The medicine fridge temperatures were appropriately recorded and monitored and vaccine stocks were well managed."

Positive

"The practice had action plans in place to address areas highlighted in the CCG medicine management data as being outside the medication prescribing limits."

Neutral

"The practice checked that patients receiving repeat prescriptions had at least an annual medicine review with the GP."

Positive

"Meetings took place with other health care professionals for example palliative care on a regular basis when care plans were routinely reviewed and updated for patients with complex needs."

Positive

"• GPs who were skilled in specialist areas such as family planning and palliative care used their expertise to offer additional services to patients."

Positive

"• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life."

Positive

"Care plans were in place for patients on palliative care and the GP supported patients with discussion about end of life preferences as appropriate."

Positive

"We saw evidence of collaborative working with palliative care staff which resulted in positive outcomes for the patients concerned and the GP lead was also the Clinical Commissioning Group CCG lead for cancer care."

Positive

"We were provided with examples of joint working with palliative care nurses."

Positive

"For example regular updates were sent to the out of hour’s service in relation to patients receiving palliative care."

Positive

"GPs met regularly with the practice and palliative care nurses and administration staff."

Positive

"This was via the telephone access service with no requirement to speak with a receptionist and the computermobile access service."

Positive

"They found that regular discussion points for patients were car parking the premises a lack of windows in the waiting room and therefore a potential need for air conditioning and automated doors for patient access."

Neutral

"There was minimal car parking available."

Positive

"There were early and ongoing conversations with these patients about their end of life care as part of their wider treatment and care planning."

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

"For example: • Patients receiving end of life care carers those at risk of developing a longterm condition and those requiring advice on their diet smoking and alcohol cessation."

Positive

"Governance arrangements We saw systems in place for monitoring all aspects of the service such as complaints incidents safeguarding risk management clinical audit and infection control."

Neutral

"The practice had a system in place for completing clinical audit cycles."

Positive

"• There was a health and safety policy available."

Neutral

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

Positive

"Equipment used to store current records on all types of media should provide storage that is safe and secure from unauthorised access and which meets health and safety and fire regulations but which also allowed maximum accessibility of the information commensurate with its frequency of use."

Neutral

"• The senior practice nurse was the infection prevention and control IPC clinical lead."

Neutral

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

Positive

"Complete an appropriate Legionella risk assessment and conduct appropriate infection prevention and control audits."

Neutral

"• Complete an appropriate Legionella risk assessment and conduct an infection prevention and control audit."

Positive

"There was a cleaning schedule in place which also identified areas in receipt of a deep clean curtains were cleaned every three months a cleaning record was held for each room."

Positive

"The practice cleaner was on annual leave and staff at the practice were tasked to complete the cleaning tasks."

Neutral

"Cleaners were employed and there was a cleaning schedule in place to make sure each area was thoroughly cleaned on a regular basis."

Positive

"We noted there was no power assisted entrance door to the practice and the reception desk was not at a lower level to facilitate access by wheelchair users."

Neutral

"Corridors and doorways were wide enough to accommodate wheelchair access."