The Connaught Square Practice

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

At our last inspection in August 2018, we rated this key question as Good. At this assessment in December 2025, the rating remains the same.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice mostly made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. However, some improvements were required.

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. Systems were in place to complete medicine reviews. However, our clinical records searches identified some gaps in medicine reviews for patients with asthma and patients prescribed bisphosphonates. The practice acknowledged these findings and demonstrated a willingness to improve, advising that regular audits of medicines review documentation were planned to promote consistency and ensure all required checks were completed.

Feedback from people using the service was positive. People felt involved in any assessment of their needs and felt confident that staff understood their individual and cultural needs.

Reception staff were aware of the needs of the local community. Reception staff 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.

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 practice planned and delivered people’s care and treatment with them, including what was important and mattered to them. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. However, care and treatment was not always delivered in line with current guidance. For example, we found patients who had received steroid treatment for an acute exacerbation of asthma were inconsistently followed up within an appropriate timescale to check response to treatment, as outlined in National Institute for Health and Care Excellence guidance. The provider informed us that some patients did not attend their follow-up appointments, however the provider recognised the process for follow-up should be improved. The provider was responsive and during our assessment submitted an improvement plan and protocol to address the gaps in their current system.

The practice 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. All relevant teams and staff were given access to information and guidance as they were made available.

The practice 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. Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity.

The practice did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Childhood immunisations were carried out in line with the national childhood vaccination programme. However, according to the UK Health Security Agency (UKHSA) published data, the practice childhood immunisation uptake rates were below the World Health Organisation (WHO) target of 95% for all 5 immunisation indicators measured in 2024/25, which were recorded at 47%, 59%, 62%, 62% and 68% respectively. The practice explained that this was due to the transient population and challenges within the practice area. For example, the practice identified that some children were not living in the country or had childhood immunisation carried out in their native countries, but formal evidence of immunisation had not been shared with the practice. The practice told us that it had a high proportion of asylum seekers and patients from European backgrounds, who did not wish to have their children vaccinated despite several attempts to raise awareness about the importance and benefits of the programme with posters, text messaging and telephone calls. The practice informed us there was a high refusal rate for immunisation for measles, mumps and rubella (MMR).

The practice had taken steps to improve childhood immunisation uptake. For example, they increased practice nurse working hours and offered weekend nurse clinics (as part of the primary care network). The practice engaged with pregnant women at an early stage to promote awareness of the benefits of vaccination. They displayed posters and leaflets in the practice encouraging childhood immunisation uptake.

According to the NHS England published data (30 June 2024), the practice population uptake rates for cervical cancer screening programme were below the England average. They achieved 50% cervical cancer screening rates for women aged 25-49 years and 58% screening rates for women aged 50-64 years old. The practice explained that this was due to the transient population, high number of asylum seekers and known cultural beliefs within the practice population.

The practice had taken steps to encourage uptake. For example, the practice increased nurse working hours, offered weekend nurse clinics (as part of the primary care network) and recruited an Arabic speaking member of staff to support engagement and encourage patients to attend for screening.

The practice nurse had received regular annual training updates relevant to childhood and travel immunisations.

Audits of long-term conditions were done to check for abnormal blood sugar levels and chronic kidney disease risk. Care plans and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) records were completed and reviewed regularly.

The practice 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. Our review of notes where a DNACPR decision had been recorded, identified that where possible, the patients’ views had been sought and respected. We saw that information had been shared with relevant agencies.