Henmore Health - Brailsford 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. This is the first assessment for this service since its registration with CQC. This key question has been rated 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 people’s needs. For example, Recommended Summary Plans for Emergency Care and Treatment. Appointments for people with a learning disability or autism were longer, adjusted, and enabled them to be supported by carers, where appropriate.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed people were supported to understand their condition and were involved in the planning for their care needs. GPs worked closely with the palliative care nurses to establish effective support for people near the end of their life.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. We saw the practice worked in partnership with other services to meet the needs of its patient population. For example, care homes and the community support team.

Relationships between the practices within the local Primary Care Network (PCN) had broken down and the PCN was no longer in place. Temporary measures were in place to ensure people continued to have access to services provided by the PCN for example, extended access appointments and physiotherapy and mental health services. The provider was exploring a long-term solution to ensure that services continued seamlessly for people. The provider had identified the need for a pharmacy rather than a dispensary within the practice. This would provide items over and above medicines, such as nappies and baby milk, within the local community for people. They were in the process of securing the required agreements for this.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The practice had access to interpreter services, including British Sign Language and provided longer appointments for this group of people. Alerts were added to the records of people who needed additional support. For example, people with a hearing or visual impairments or those whose first language was not English. Information provided by the service met the Accessible Information Standard. People were informed as to how to access their care records.

The service supported people to share feedback and ideas, or raise complaints about their care, treatment and support. For example, through patient surveys and the Patient Participation Group (PPG). Data from the latest national GP patient survey showed that 93% of respondents felt involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment. This was comparable with the national average of 91%. Staff were aware of how to support people to submit complaints to the practice. The service 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 practice’s policy. Learning from complaints was evident and shared with clinical staff at clinical meetings. Non-clinical staff were made aware of complaints when appropriate. A system for identifying trends in complaints had been put in place following our assessment of the provider’s other GP practice.

An action plan had been put in place to address patient feedback obtained through patient surveys and the Patient Participation group (PPG). For example, the introduction of the medicine home delivery service, the new telephone system and total triage for access to appointments. The practice provided a quarterly newsletter to keep patients up to date with changes within the practice.

We received mixed feedback from the Patient Participation Group (PPG). They told us they were involved and listened to when the practice took over the practice. However, when they had challenged the practice over issues such as the new triage form, their requests for information had not been responded to.

The service made sure that people could access the care, support and treatment they needed when they needed it. People could access the service to suit their needs for example online, in person and by telephone. Treatment rooms were available on the ground floor and automatic doors had been fitted to the entrance. However, a disabled parking space was not available in the practice’s car park to support people with a mobility issue. Reception staff told us they had never had a complaint about this from people. The issue had been identified on the practice’s risk register. Succession planning to build a new GP practice on nearby land owned by the provider was in place. Disabled parking would then be made available.

Data from the national patient survey showed that 64% of respondents responded positively to the overall experience of contacting their GP practice. This was comparable with the national average of 70%. Fifty-six percent of respondents responded positively to how easy it was to contact their GP practice on the phone. This was comparable with the national average of 53%. We received 1 negative complaint about telephone access to the practice as part of this assessment. In response to the National GP Patient Survey data and feedback from people, changes to improve access to the service had been put in place. For example, a new telephone system and an online triage form which people could complete between 6am to 5pm.

A representative from a care home where the service provided care and treatment told us that their email requests were responded to quickly but telephone access was slow.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience. For example, the introduction of a medicine home delivery service. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. If someone was unable to complete the online triage form to gain access to an appointment, they could call the practice on the telephone and a care navigator completed the form for them.

A representative from a care home where the practice provided care and treatment told us that the service was responsive to their concerns and they could contact the practice by email if they required anything and that they received a prompt response. They told us that GPs were responsive when they had requested a visit for a person living in the care home.

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 review of patient records 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.