Henmore Health - Brailsford Surgery

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. This is the first assessment for this service since its registration with CQC. This key question has been rated as Good.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There were processes in place for staff to report incidents, near misses and safety events and staff we spoke with were aware how to do this. Our review of significant events showed that lessons were learnt. Minutes from clinical and quality meetings showed significant events were discussed with clinical staff that attended these meetings. Trends in significant events had been assessed. A representative from the Patient Participation Group (PPG) felt the practice took concerns seriously and proactively made improvements to the service. However, one person told us how they had raised a significant event about their personal safety within the practice and it took 6 months before it was dealt with.

There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from complaints resulted in changes that improved care for others. An annual audit of complaints had been carried out by the provider to identify trends in complaints.

Staff feedback was mixed when we asked if learning from significant events and complaints was shared with them. Clinical staff were mostly positive that learning was shared with them however, some non-clinical told us learning had not been shared with them.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. Data from the National GP Patient Survey data showed that 93% of respondents stated that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment. This was comparable with the national average of 91%.

The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. People’s communication needs were met to enable them to be fully involved in their care. The practice had identified 250 people registered with the service as carers which was 4.8% of the practice population. Systems were in place to support this group of people.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. Staff helped people and their carers to access advocacy and community-based services. Reception staff supported people to complete the online triage form if they were unable to complete this themselves.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs and acted to minimise any discomfort, concern or distress. Two members of staff described 3 examples where they had taken distressed patients to a private room and called the GP immediately to ensure their safety was maintained. Data from the GP patient survey showed that 92% of respondents stated that during their last appointment they had confidence and trust in the healthcare professional they saw or spoke to. This was the same as the national average.

There was an appointment triage process in place that ensured people with immediate needs had access to services. Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams.

The service did not always care about and promote the wellbeing of their staff. We received 5 staff feedback forms and 6 anonymous contacts from staff who did not feel confident to speak out during the assessment. We interviewed 12 members of staff as part of our assessment.

Staff feedback was mixed. Some staff told us they were valued by leaders who had taken steps to recognise and meet the wellbeing needs of staff. This included the necessary resources and facilities for safe working, such as regular breaks and rest areas and individual support for staff’s wellbeing and health needs. Team building days were established within the practice. For example, a summer BBQ and Christmas meal paid for by the partners. Some staff told us of reasonable adjustments that had been made within the work place to support them in their work.

However, some staff told us their wellbeing was not considered and there was a bullying and oppressive culture within the practice. One member of staff told us that after being off sick for several months they were not provided with a return to work interview. They felt unsupported throughout the process because they were told patients were more important than their personal safety. One member of staff highlighted issues around lone working at the practice. Some staff told us they were not aware of anything in place to support their wellbeing.