Carlisle Central Practice

On this page

• 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

Responsive – this means we looked for evidence that the provider met people’s needs.This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s needs were met through good organisation and delivery.

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 provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

The provider understood the diverse health and care needs of people and their local communities, so care was mostly joined-up, flexible and supported choice and continuity. We did see an example of a time where a patient almost missed a placement with a service due to a delay in information being shared by the practice with other services, however the provider gave us evidence of the processes they have in place to improve communication with partners, such as a dedicated phone line which bypasses the need to contact reception.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information provided by the practice met the Accessible Information Standard. Individual communication needs were noted on the patient’s record. Staff told us they supported patients with using online services.Leaflets were available in the reception area and posters were displayed to provide patients with information on the practice and the different services available to them. Patients were also provided with information on how to access their medical records.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

There was a complaints process in place, which included a designated complaints lead and a policy. Information on how to make a complaint was available on the practice's website. We reviewed a number of complaints and found they were actioned in line with their policy. Where appropriate, patients were provided with an apology and signposted to the Parliamentary and Health Service Ombudsman. The practice conducted an annual review of complaints which looked at themes, learning points, changes made and other planned actions.

The provider faced challenges in making sure that people could access the care, support and treatment they needed when they needed it. Patient feedback we received during the inspection stated that people struggled with access. Fifteen of the 26 patients we spoke to told us they found it difficult to contact the practice either by telephone or online, and that there were rarely appointments available. However, the results from the National GP Patient Survey showed that 61% of patients found it easy to contact the practice by phone, compared to a national average of 50%. Reviews left on the NHS website were also mixed, with some patients saying it was difficult to make appointments while others praised the practice.

We checked the appointment system on the day of the inspection at 12.15pm and there were no GP appointments available for the remainder of the day. However, there were extended access appointments with an Advanced Nurse Practitioners available for later in the day that receptionists could book patients into. There were 5 Advanced Nurse Practitioner appointments, 7 GP appointments, and 7 additional embargoed appointments available the following day which would be released from 8am. Receptionists had been trained to care navigate to other services, such as physiotherapy. We received feedback that a GP was not always available at both practice sites, however we checked 3 random dates during the previous 2 months and found GPs were at both sites on each of the days.

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 and Travellers. Staff used appropriate systems to capture and review feedback from people using the practice, including those who did not speak English or have access to the internet.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Our records review showed people were supported to consider their wishes for their end-of-life care, including do not attempt cardiopulmonary resuscitation (DNACPR). This information was shared with other services when necessary.