DeMontfort Surgery

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. Staff regularly reviewed people’s care and worked with other services to achieve this.

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

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.

Feedback from people using the service regarding their experience with clinicians was positive. Staff were aware of the needs of the local community and understood patients individual and cultural needs. The practice used digital flags within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present.

Staff checked people’s health, care, and wellbeing needs during health reviews. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. The provider had effective systems to identify people with previously undiagnosed conditions.

Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. There was evidence of clinical updates being highlighted to staff. Clinical records we saw demonstrated care was provided in line with current guidance.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

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.

When issues with communication between services had been picked up, the practice escalated these appropriately and improved systems for sharing across external organisations within the locality to improve patient care. The practice provided healthcare to a care home, who reported a positive working relationship with the clinicians who provided regular ward rounds to review residents.

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

Staff focussed on identifying risks to patients’ health, including those in the last 12 months of their lives, patients at risk of developing a long-term condition and those with caring responsibilities.

The provider had developed initiatives to identify patients at risk of developing some long-term conditions to improve outcomes for these patients. Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity.

The practice had support from a mental health practitioner to support the patients within the practice, where they had highlighted that their student population may need additional support with their mental health needs.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

We reviewed the practices outcomes for screening and immunisations. The latest verified data held by CQC showed the practice was achieving an uptake rate of 40% of cervical screening for eligible patients in 2023. We reviewed unverified data the practice provided us which showed at the time of our inspection, the practice had increased this to 50% for eligible patients. The practice reported that challenges included cultural beliefs as well as patients who frequently move away from the practice as to why their figures were low.
Our verified data for childhood immunisations in 2023 to 2024 showed the practice was not meeting the 80% uptake rate for two out of the three childhood immunisations recommended for children aged 2. The provider employed a specialist immunisation nurse to attempt to drive improvements in this area. At the time of our inspection, the lead nurse had ideas on how they wanted to encourage uptake however had not put all plans into action. The practice would contact patients and encourage them to attend for screening or immunisations.

 

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

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.