Old Road Medical Practice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this. At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.

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.

Following the findings at the previous assessment where we found discussions about people’s healthcare, and communication needs had not always been recorded in people’s records to ensure their care and treatment was effective, we checked for improvements. At this assessment we found changes had been made to the templates used by staff to include discussions with people about healthcare, wellbeing, and communication needs during healthcare appointments.

Feedback from people using the service said they felt involved in their care and treatment and were confident that staff understood their individual needs. Feedback from care home representatives was positive about the practice services provided to their residents.

Reception staff showed us the digital flags within the patient computer records system to highlight specific people’s needs, such as the requirement for longer appointments or for a translator to be present. We found staff were aware of the needs of the people in their local community.

Following our previous assessment processes had been set-up to improve patient monitoring. Staff told us they checked people’s healthcare, and wellbeing needs during medicine reviews, and followed up any on-going treatment. However, during the remote searches we found not all people had received effective monitoring. Before the onsite assessment we received assurance that any patients identified in the remote searches had already received or been booked for their monitoring. Monthly audits had been set-up and treatment templates had been updated for assurance that monitoring would not be missed in the future. These recent changes need to be embedded at the practice.

Staff could refer people with social needs, such as those experiencing social isolation or housingdifficulties, to a care coordinator/social prescriber.

Following the findings at the previous assessment we sought assurance that consistent evidence was being documented in people’s records. At this assessment we found consistent evidence was documented in people’s records using evidence-based care and treatment templates. Staff told us they used the computer records library on their system to support them with up-to-date evidence-based guidance and legislation. We saw staff used clinical evidence-based templates when conducting health reviews to support people’s wider health and wellbeing for long-term condition management. Although we found small numbers of people that had not received the monitoring in line with current guidance, we received assurance following the remote searches that people had received or been booked to receive the correct monitoring. The practice had designed a monthly audit process to ensure people’s monitoring was not missed for the future. This process had not been fully embedded at the practice.

The people we spoke with at this assessment told us they were satisfied with the way the practice delivered care and treatment.

People with multiple long-term conditions were reviewed where possible, during one longer appointment. Arrangements were in place to coordinate any tests people required so that results were available at the time of their review appointment.

The practice worked well across teams and services to support people. They shared assessments of people’s needs when they moved between different services, this ensured people only needed to tell their story once.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice worked with other services to ensure people received continuity of care.

Arrangements were in place for practice teams to support each other during periods of staff sickness, annual leave, and busy periods of the day within the practice. For example, staff were trained to support receptionists at times of peak telephone demand.

The practice supported people to live healthier lives and where possible, to reduce their future need for treatment and support.

People who provided feedback had no concerns in this area. Representatives from care homes told us people in their care received general and specific health checks.

NHS health checks were offered to people aged 40 to 74 years. Healthy living information was available in the waiting room, around the practice and on the practice website. There was a well-placed information board in the waiting room that provided information about services available to the local population.

Clinical staff described how they supported national priorities and initiatives to improve population health, this included stopping smoking and tackling obesity. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties to appropriate services.

Staff identified risks to peoples’ health, including people at risk of developing a long-term condition, those with caring responsibilities and in the last 12 months of their lives.

The practice routinely monitored people’s care and treatment continuously, for positive, consistent patient outcomes, and met both clinical expectations and people’s expectations.

Practice staff had worked to improve the uptake of childhood immunisation. Although all 4 indicators did not meet the World Health Organisation (WHO) target of 95% they had all improved over 6% since the previous assessment and the practice was on track within their action plan to meet the WHO target.

The nursing team were working towards improving their cervical screening recall system as they had missed the target of 80% achieving 66.7% in the most recently published data available. We saw arrangements were in place to follow up people when they did not respond to an invitation or attend their appointment.

The practice told people about their rights to consent, and respected peoples’ wishes when delivering person-centred care and treatment. Feedback provided by people we spoke with told us they felt at ease during consultations, were listened to, procedures were explained, and consent was requested. Feedback from people who had undergone procedures at the practice showed positive satisfaction.

Clinicians told us they supported people to make decisions, and where appropriate, assessed and recorded a person’s mental capacity and decisions as part of the consent process. Clinicians told us they always obtained consent from people and offered a chaperone where appropriate, which was recorded on the clinical system. We saw posters attached to treatment room doors to remind people they could request a chaperone.

Staff who carried out chaperone duties were trained for the role and had received a disclosure and barring (DBS) check.

Capacity and consent were recorded in peoples’ records. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.