Church Walk 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.

We found people were at the centre of their care and treatment, the service had a good understanding of the practice’s patient diversity and individual needs, they provided care and information appropriate to all. The constraints of the building limited access to patients with protected characteristics,

This is the first assessment of the service and we rated this key question 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 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 peoples’ needs.

Our review of clinical records showed that the people were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

People expressed strong confidence in the clinical staff, including GPs, Advanced Nurse Practitioners and Nurses. They felt listened to and not rushed during appointments. In addition, people commented that GPs and nurses provided follow up to treatment, tests results and referrals.

The latest NGPPS results indicate 98% of respondent had confidence and trust in the healthcare professional they saw or spoke to during their last general practice appointment and 80% felt their mental wellbeing had been considered. These scores are above both local and national results.

The service has a good understanding of the diverse health and care needs of people and local communities. Due to the rurality, size of the practice and a stable workforce, many patient'sindividual needs were known by the staff. This enabled the service to deliver care that is joined-up, flexible, individual and supports choice and continuity. For example, staff told us they recognised patients who had a specific requirement in relation to their appointment and would facilitate that as appropriate.

There is continuity in peoples’ care and treatment because services are flexible and joined up. The PCN staff who delivered care to patients registered at the practice had specific roles and provided continuity of care to the care home residents with input from the practice as required.

The provider has devised a plan that ensures patients who cannot access the practice due to constraints of the building can receive care by providing home visits.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The practice had access to interpreter/ translation services and a hearing loop. Information in an easy read format was available for those who needed it and assistance dogs are welcomed in the practice.

A range of information on aspect of health for all ages and local support groups was on display in the practice, on social media and the practice website. Multiple health information leaflets available which can be printed in other languages if required.

People know how to access their health and care records and decide which personal information can be shared with other people, including their family, care staff, school or college. The clinical system identified when a young adult needed to agree that other people can order medication or access their health information. We saw evidence that consent forms had been completed appropriately on the clinical system.

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 practices’ policy. Information on how to escalate concerns was shared with people in the practice response and in the complaints leaflet. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints. For example, the introduction of the new telephone system allowing text reminders for appointments to be sent to patients which also lets patients cancel appointments if no longer required.

The service routinely asked people to complete FFT feedback forms and reviewed the feedback for any trends or themes. Feedback was overwhelmingly positive.

Feedback from the care home we spoke with was very positive about how people were listened to especially the way the practice liaised with the Home Care Team, who carried out a weekly ward round and the care home staff if required.

People can access the care, support and treatment they need when they need it.

Physical access to the building can be limited for patients with mobility issues who use some adapted wheelchairs due to the constraints of the building. Narrow corridors and toilet facilities do not allow all wheelchair users to attend the practice. This contravenes UK Law according to the “Equality Act 2010” which protects the rights to equality for patents with a disability when using healthcare facilities. The provider has put in place a system that means patients who cannot physically access the building do receive appropriate healthcare in their own home.

The provider has been looking for alternative accommodation for some time and also has an alternative plan in place to extend the current building to provide a service that is accessible to all. They have been working with the Lincolnshire ICB for to access and secure funding to realise either of the aforementioned plans. This is ongoing and at the time of our report no solution is confirmed.

There is level access to the building, with clinical rooms on the ground floor, parking is very limited but there is designated disabled parking space.

The practice is a small, rural practice and the staff know most of the patients, they recognise who required extra support or time and offer extra length appointments and added support to anyone who needs them.

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. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not have access to the internet.

People were 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 people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. This information was shared with other services when necessary. For example, the care home we spoke too confirmed that the practice believes in continuity and they tend to have the same GP visit who knows and understands the residents to discuss their end of life wishes and provide appropriate.

The care of people in the care home following the end of life (EoL) pathway was overseen by the Home Health Team who discuss patients as appropriate with the practice. Practice GPs do not visit residents deemed to be EoL regularly but if requested by the care home they confirmed a visit takes place.