What is the Quality of Facilities at The Nile Practice

Positive

"The clinical staff at the practice met every four to six weeks with the community nurses and palliative care team to discuss patients identified with palliative care needs."

Positive

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

Neutral

"• The practice held and minuted a range of multidisciplinary meetings including meetings with district nurses and palliative care nurses to monitor vulnerable patients."

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 in the electronic records."

Neutral

"This was because: • Evidence of satisfactory conduct in previous employment had not been obtained for all newly appointed staff and the practice could not demonstrate that the practice nurse had indemnity insurance in place."

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."

Positive

"The practice nurses told us that now the computer systems at all three sites had merged they would be able to start monitoring their performance against the Quality and Outcomes Framework QoF for the whole practice population."

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 cleaning schedules and monitoring systems in place."

Neutral

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

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."

Positive

"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 or substance misuse."

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

"Improvements were also required around the introduction of regular significant event meetings and health and safety training for staff."

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

"• The practice nurses were the infection prevention and control IPC clinical leads who liaised with the local infection prevention teams to keep up to date with best practice."

Neutral

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

Neutral

"There were cleaning schedules and monitoring systems in place."

Positive

"• The practice carried out regular medicines audits with the support of the local clinical commissioning group medicine optimisation team to ensure prescribing was in line with best practice guidelines for safe prescribing."

Positive

"The practice had supported the health care assistant to extend their skills to enable them to give injections for specific medicine to patients."

Positive

"There was evidence of quality improvement including clinical audit: • Audits were carried out in response to medicine safety alerts or changes to guidance."

Positive

"The practice was also supported by a pharmacist who carried out searches to identify any patients who were prescribed medicines included in any medicine alerts."

Positive

"Current guidance was that this medicine should only be Are services effective?"

Neutral

"Over the three audits cycles the practice had made improvements as this medicine was only prescribed to patients on an acute prescription."

Neutral

"They had recently attended a course which enabled them to give injections of specific medicine to patients under patient specific directives."