The Warren 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 advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this. At our last assessment in December 2017, we rated this key question as good. At this assessment, the rating remains the same because we found no issues with the effectiveness of assessing, monitoring and improving patient needs and care.

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’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 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. There were digital flags within the care records system to highlight any specific individual needs. Staff checked people’s health, care, and wellbeing needs during health reviews. Care plans for patients with mental health needs were adequate. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. For example, 31 out of 36 health check reviews for patients with learning disabilities had been completed in the last year and documented from our review of the patient records. The practice had a carers’ champion; however, health checks for patients with caring responsibilities were only on patient request and not offered proactively. Flu vaccinations were provided, and patents were referred to relevant support services where needed.

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. 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 service worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services.

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, and patients at risk of developing a long-term condition. The service supported their patients to enrol for weight management programmes and uptake of discounted gymnasium memberships.

The service 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. The service did not meet national targets for cervical screening and one category of childhood immunisations (aged 5, MMR 2 doses). The practice exceeded the national target in other childhood immunisation categories. There was a system of recall to educate patients and language interpreters were used to support patients who did not engage with the health offers with their understanding of the health benefits. The impact of this action on the uptake was not yet known.

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. Our review of some DNACPR records confirmed this.