Stirling Road Medical Centre

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes and we saw care was inconsistent . Significant events showed there was a theme of incorrect information being added to people’s records, which delayed care and treatment. Improvements were needed in managing tasks to ensure information on people’s records was up to date, and action had been taken to meet their needs.

People’s records did not always accurately reflect their health needs and how these needs would be met. There were shortfalls in monitoring long term conditions.

Patients told us they had been involved in their care and treatment decisions, and thought staff were supportive. Staff were aware of how to gain consent and were able to describe support that could be offered to patients if needed.

The service was in breach of legal regulation in relation to monitoring of safe care and treatment provided; processes to manage significant events and ensure learning was shared appropriately; and management of information relating to patients.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment was effective because they did not consistently check and discuss people’s health, care, wellbeing and communication needs with them. Significant events showed people were not always assessed fully to make sure their needs were identified and met. Examples included incorrect information being added to patient records, which led to an appointment being booked for another patient and delays in getting treatment with secondary care. Review of outstanding tasks showed there were delays in assessments and treatment. For example, a patient was referred to secondary care who on receipt of the referral, had requested further information in early December 2024, at the time of our assessment this had not been acted on by the practice. Patients we spoke with onsite considered their needs were assessed. Clinical staff used templates when conducting care reviews, but these did not fully support the review of people’s wider health and wellbeing, as records did not always provide sufficient detail. Reception staff were aware of the needs of the local community. Digital flags were placed on care records to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present. The provider did not have effective systems to identify people with previously undiagnosed conditions , such as diabetes. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber. A care navigation system had been implemented.(This is where people would be asked a series of questions to find the most appropriate type of appointment for patients). Staff who were confident as care navigators said there were times when the outcome of the system directed patients to use eConsult, when the patients had already completed this.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Clinical templates based on current guidance were used to record care and treatment. However, clinical records did not fully demonstrate care was provided in line with current guidance as when reviewing patient records we found the templates were not completed fully and tasks were not flagged for action. For example, a patient was experiencing blood loss and needed blood tests. The patient had been prescribed medicine to help with the blood loss during a telephone call. No timescale had been noted on their record regarding the timescale for when the blood test should be done and what further actions were needed. At the time of this assessment another patient had been waiting since November 2024 for a routine face to face appointment to discuss their condition. No flag or information had been placed on their record to ensure they received timely care and treatment.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

We saw a physiotherapist requested a local anaesthetic (used to numb the skin), but the medicine was not readily available. This meant the most effective care and treatment was not provided. Concerns were received from other service providers about poor communication about patients’ needs .

Tasks were not always reallocated when staff stopped working at the practice. Examples included information regarding a change in medicine from district nurses in March 2024. At the time of our assessment this had not been done.

The provider gave assurances they would check the tasks list and remove staff who had left and delete their task box, so tasks could no longer be allocated to them.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

TV screens and posters in the waiting area and the practice website had information on wellbeing and support available for patients. This included bereavement support, support with mental health and living with a long term condition.

Machines for patients to measure height, weight, blood pressure and body mass index were in reception areas. Patients were able to get a printout which was added to their records by reception staff. The provider planned to link these machines to their system, so the information would be put directly onto patient records.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and

consistent, or they met both clinical expectations and the expectations of people themselves.

Results from our clinical searches showed there were shortfalls in monitoring long term conditions. For example, patients who had exacerbations of asthma and needed steroids (a medicine to reduce inflammation) were not routinely followed up within a week. There were also shortfalls with ensuring relevant blood tests and physical checks had been carried out prior to a review or prescription being issues.

People were told about their rights around consent. Staff understood and applied legislation relating to consent. Capacity and consent were clearly recorded. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation. Staff told us how they would assess a person’s capacity to make a decision. However, training records showed not all staff had receive training on the Mental Capacity Act 2005. Staff we spoke with understood consent in young people and there was a process to ensure young adults had control over their own privacy and the amount of parental / carer involvement in managing their care and support.