Archived: Little Lever Health Centre-2

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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 assessed all quality statements in this key question.

People were not always involved in decisions about their care. The service provided information people could understand. People knew how to give feedback, but it was not always appropriately investigated or acted on. The service was easy to access but appointments did not run to time. The service worked to reduce health and care inequalities through training. People were usually involved in planning their care and understood options around choosing to withdraw or not receive care.

This is the first inspection for this service since its registration with CQC at the current location. This key question has been rated as requires improvement.

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.

People received the most appropriate care and treatment for them, although they were often not seen on time. The service made reasonable adjustments where necessary.

Staff and leaders gave examples of people receiving the most appropriate care and treatment for them as the service made reasonable adjustments where necessary. However, they also told us, and we saw evidence that, surgeries were usually delayed by a long time, often over an hour, and this had an impact on people.

Staff had a good understanding of the demographics of the area. Staff and leaders told us appointments were flexible, and the provider met the needs of some people by not rushing them during appointments. However, this had a knock on effect for other people whose appointment times were delayed

Partners had no specific feedback on this area.

Usually, people’s care and treatment was delivered in a way that met their assessed needs. The practice worked with services in a coordinated and responsive way. However, the needs and rights of young people were not always considered.

People received information and advice that was accurate, up to date and provided in a way that they could understand. However, they were not able to decide which personal information was be shared with other people, including their family.

Although staff had completed training in General Data Protection Regulation (GDPR), we saw the provider did not have a good understanding of when it was appropriate to share information.

The practice had up to date information governance and data protection policies. The practice was registered with the Information Commissioner's Office. The practice had access to interpreter services, including British Sign Language, although the service was rarely required. Patients were informed as to how to access their care records.

People could provide feedback about their care, but concerns were not always appropriately acted on. There was a patient participation group (PPG), but this only met annually.

Leaders told us they were unable to interact with the PPG more often than once a year due to time constraints. Staff told us there were a lot of complaints about surgeries running late, but these were informal. They said they raised these concerns with the provider, but improvements had not occurred.

The practice had a complaints log, but this did not detail if the complaint was upheld or not. The complaints policy was not clear. It stated the practice manager could decide if a complaint was formal or informal, and if an issue could be resolved within 10 days it could be categorised as a concern and not a complaint. It stated a written response would be given to written complaints, but we saw an example of a written complaint with no written response. Final responses did not give information about how a person could escalate their complaint if they remained dissatisfied; the policy stated this should be included in final responses. The provider responded to complaints made about them, with no input or oversight from anyone else. Responses were not always appropriate. The policy stated all new complaints, resolutions and any learning from complaints would be discussed at practice meetings. Meeting minutes showed that this was not the case.

People could access care, treatment and support when they needed to and in a way that worked for them. This promoted equality, removed barriers or delays and protected their rights. The National GP Patient Survey results for being able to contact the practice by telephone, and for being given a choice of appointment times and days, were above the national and local average.

Staff and leaders explained how the appointment system worked and told us people never had to wait a long time to be booked in for an appointment. Telephone and face to face appointments were available. Staff told us that although people could access appointments, they usually had to wait a long time after their given time to see the provider, as most surgeries ran very late.

People could make appointments by telephone or the NHS app and we saw evidence that people did not have to wait a long time to access an appointment. We saw there were choices for patients, and there was a wider health team available when seeing a GP was not necessary. We saw evidence that when people attended the surgery for an appointment, they usually had to wait a long time to see the provider. It was not unusual for patients to be seen over an hour late due to the length of time the provider spent with people.

Feedback provided by people using the service, both to the provider as well as to CQC, was usually positive. Staff treated people equally and without discrimination.

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

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people.

People were supported to plan ahead for important changes in their lives.

Staff made sure that when people wanted to express their wishes about cardiopulmonary resuscitation (CPR), they were supported to do so and were able to change their mind if they wished. Leaders made sure external services were involved or updated when needed.

The practice had processes in place to help people plan ahead for important changes in their lives. We saw evidence that staff acted without discrimination when supporting people and their families to make decisions.