Cranbrook 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 assessed all quality statements in the effective key question.

This is the first inspection for this service since its registration with CQC. At this assessment, we rated the key question as Good. Staff involved people in decisions about their care and treatment and provided them with advice and support. Staff regularly reviewed people’s care and worked with other services to meet their needs.

This service scored 75 (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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff were aware of the needs of the local community. Digital flags on patients’ records highlighted additional support, such as the requirement for a translator and the need for a longer appointment. People felt involved in the assessment of their needs and felt confident staff understood their individual needs. People presenting with symptoms which could indicate serious illness were followed up in a timely way. We reviewed the appointment diary and saw appointments were available to book the same day for urgent appointments.

We identified 846 patients on the practice’s asthma register and 33 of them had been prescribed 2 or more rescue steroids (treatment for severe asthma episodes) in the last 12 months. We reviewed 5 of these patient records and all had been thoroughly assessed and reviewed appropriately. The documentation was of high quality.

The practice had systems to ensure staff were up-to-date with evidence-based guidance and legislation. The practice had regular clinical meetings where guidance and cases were discussed.We saw evidence of clinical audits being undertaken to ensure they were meeting clinical guidelines. Staff told us they had protected time to complete continuous professional development. The practice supported and encouraged staff to pursue further training in their specific areas of interest.

The service worked well across teams and services to support people.

Staff appreciated their colleagues and enjoyed the team working environment.Staff were able to request support from GPs and the leadership team who were visible and approachable. 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 or received from other services. On the day of the clinical searches, there were 39 incoming documents awaiting processing, of which the majority were received the day before searches. There were 25 results awaiting filing, of which all were received within 3 days from the day of clinical searches.The results have been reviewed and they did not pose any risks to patients.

Feedback from partners indicated good working relationships with staff from the practice.The practice worked closely with the local school and community groups to promote healthy and active lifestyle and to provide joined-up support for vulnerable members of the community.

The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff had a holistic and joined-up approach to supporting people and discussed patient care in clinical and complex care meetings. The practice identified people who may need extra support and directed them to relevant services. This included people in the last 12 months of their lives and people at risk of developing a long-term condition and those with caring responsibilities. We observed various health promotion patient leaflets throughout the practice waiting area advising people on health and wellbeing topics. The practice was a registered parkrun practice which actively promoted physical activity among their community. The practice signposted people to a healthy lifestyle programme when appropriate.

The service monitored people's care and treatment to ensure continuous improvement.

People with long-term conditions were offered an annual review to check their health and to ensure their needs were being met. The practice had designated staff whose role included recalling people for reviews, follow-ups and screening. Our clinical searches identified 29 patients with diabetes who had a HbA1c at 75mmol/mol or above (a high average blood sugar level indicating increased risk of complications). We reviewed 5 of these patient records and found all the patients received monitoring and appropriate well-documented reviews. We looked at the potential missed diagnosis of diabetes as part of our clinical searches and 1 patient was identified to be at risk. The practice reviewed the patient record and found the patient record had been incorrectly coded as ‘diabetes resolved’ while still on treatment for diabetes. The practice conducted a significant event analysis, carried out corrective actions and implemented a new process to ensure people were coded correctly and received necessary monitoring.

The practice had met the 95% national target for 4 of the childhood immunisation indicators and was slightly below the 90% minimum uptake target for 1 of the childhood immunisation indicators. Children who were not brought to appointments were followed up with contact made with their parent or carer. The practice was aware of their patient demographics with a much higher proportion of babies and children than other practices. They reviewed the appointment system and the practice allocated more time slots for baby immunisation to meet their needs. Latest verified national data (dated 30 June 2023) showed thatthe percentage of eligible people who had received cervical screening within a set timeframe had not met the national target (at 79% against the national target of 80%). However, unverified more recent data provided by the practice demonstrated they had met the national target.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff explained to us how they spoke with people and gained consent. Capacity and consent were clearly recorded. Staff had completed Mental Capacity Act training. Policies, protocols, and guidance were followed to support people to consent to care and treatment. Clinicians supported people to make decisions.