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. We also looked for evidence that staff were regularly reviewing people’s care and worked with other services.

At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.

At this assessment we found the service was in breach of a legal regulation in relation to Regulation 12 - Prevent people from receiving unsafe care and treatment and prevent avoidable harm or risk of harm.

This service scored 58 (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 did not always make sure people’s care and treatment was effective because we did not find documented within some records checks and discussions of people’s healthcare, wellbeing and communication needs. However, feedback from people using the service felt involved in their care and treatment needs and were confident that staff understood their individual needs. Reception staff showed us the digital flags within the patients computer records system to highlight specific people’s needs, such as the requirement for longer appointments or for a translator to be present. Staff told us they checked people’s health, care, and wellbeing needs during medicine reviews, follow-up and on-going treatment. However, we found during the remote searches carried out on the patient record system not all people received effective monitoring. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. The provider did not always identify people with previously undiagnosed conditions. For example, there were a total number of 165 people that had potentially missed a diagnosis of chronic kidney disease (CKD) stage 3, 4 or 5. CKD is identified by regular blood monitoring. We reviewed 5 patient records of the 165. Within the 5 records we reviewed, 1 person although receiving blood monitoring did not appear to have CKD, 2 people had been missed for diagnosis of CKD and 2 people had not received their repeat blood test monitoring to confirm their diagnosis. This placed people at risk of CKD being missed for a diagnosis. A delay receiving treatment would negatively impact patient outcomes. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

Our remote clinical searches did not find consistent evidence documented that the practice always delivered evidence-based care and treatment, when we carried out the remote searches of the patient computer record system.

Staff told us they used the computer records library system to keep up to date with evidence-based guidance and legislation. However the clinical records we reviewed demonstrated care was not always provided in line with current clinical guidance, for example, some long-term condition monitoring was missing.

Staff at the practice told us they worked well across teams and services to support people. We found 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 continuity of care, including where clinical tasks were delegated to other services.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The service did not always make sure that medicines and treatments were safe and met people’s needs. We found some people were missing monitoring for their long-term conditions and specific medication monitoring regimes. This meant not all people with long term conditions had received treatment management to keep them safe. We identified:

49 people with asthma were prescribed 2 or more courses of rescue steroids in the last year. We reviewed 5 of the 49 records. 2 people did not had a follow-up review. This meant a risk that people without a follow-up may not recover effectively or receive further treatment putting people at risk.

45 people with hypothyroidism had not received a thyroid function test (TFT) monitoring in the last 18 months. We reviewed 5 people's records, none of the 5 had received a review in the last year. This meant people with hypothyroidism were not monitored to see if their medication dose was effective, which put them at risk of harm.

151 people with diabetes at the practice with an HbA1c greater than 75mmol/l. NICE guidance states people with HbA1c greater than 75mmol/l should receive annual long term condition reviews. 5 people's treatment records we reviewed with an HbA1c greater than 75mmol/l and we found 2 people had not received an annual review or a medicine review. This meant not all people with diabetes were followed up to ensure they were receiving the correct dosage of medicine or being effectively managed.

The practice did not meet many of the national or local targets for screening and immunisations. For example, Cervical Screening at practice 67%, the expected uptake was 80%.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.