Lytham Road Surgery

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

This is the first inspection for this service since its registration with CQC. This key question has been rated as good.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service usually made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care. However, we were concerned that records relating to do not attempt cardiopulmonary resuscitation (DNACPR), best interests decisions and mental capacity assessments did not always support or evidence this.

The practice received above average scores in the National GP Patient Survey for questions linked to patient centredness. For example, 88% of respondents stated the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment, compared to 87% nationally and 88% locally. 94% of respondents found the reception and administrative team at this GP practice helpful, compared to 83% nationally and 86% locally.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The practice was able to provide consistency for people who used the service. Results of the National GP Patient Survey indicated that 54% of patients got to see or speak to their preferred healthcare professional when they would like to, compared to 40% nationally and locally.

We saw the practice worked in partnership with other services to meet the needs of its patient population. They led and participated in multi-disciplinary teams with other professionals to meet the needs of their patients. There were established mechanisms for engaging with the community healthcare providers. Referrals to other services were made promptly and information shared by other services was managed effectively and timely to support good outcomes for people.

The practice supported vulnerable patients by monitoring when their repeat prescriptions were due on a whiteboard in the office. If they had not received the request they would remind patients and support them to make the request in order for them to continue receiving their medicines.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information to promote the take up of screening and immunisation programmes was available in a range of languages. The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard. Patients were informed as to how to access their care records.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

We saw complaints were managed in line with the practice’s policy. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints. We checked a sample of complaints and found they were handled sensitively and appropriately and that trends and themes fed into an annual review of complaints. We saw evidence of changes made as a result of complaints.

The practice had a Patient Participation Group (PPG), which was made up of patients, carers and GP practice staff which met regularly to discuss and support the running of their GP practice. PPGs look at the services the practice offers, patient experience and how improvements can be made for the benefit of patients and the practice.

The service was good at ensuring people could access the care, support and treatment they needed when they needed it.

In response to the National GP Patient Survey data, from their own patient surveys and from feedback from members of the community the provider had identified changes to improve access to the service. For example, they had extended appointments for people with a learning disability. People could access the service to suit their needs such as online, in person and by telephone. The building and treatment rooms were accessible with the use of lifts, ramps and automatic doors.

The service received above average scores in the National GP Patient Survey for questions linked to access. 86% of respondents were positive about their experience of contacting the practice, compared to 70% nationally and 73% locally. 65% found it easy to get through to this GP practice by phone, compared to 53% nationally and 57% locally. 47% found it easy to contact this GP practice using their website, compared to 51% nationally and 47% locally. 45% found it easy to contact this GP practice using the NHS App, compared to 49% nationally and 53% locally.

82% of respondents felt they waited about the right amount of time for their last general practice appointment, compared to 68% nationally and 67% locally.

The practice had analysed the results of the NHS GP patient survey and had produced an action plan to help improve aspects highlighted by the survey. They had completed some actions and were working through others at the time of inspection.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Feedback provided by people using the service, both to the provider as well as to CQC, was positive. Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet. The practice responded to feedback from patient surveys to try to improve their experience.

The results of the National GP Patient Survey showed that 89% of respondents felt their needs were met during their last general practice appointment, compared to 90% nationally and 91% locally. 81% described their overall experience of the practice as good, compared to 75% nationally and 78% locally.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Our records review showed that although people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation, this was not always documented well. However, this information was shared with other services when necessary. Following the inspection, the provider undertook a review of such cases to make sure processes and documentation was correct.