Cornerstone Medical 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, we rated this key question as Good. At this assessment, the rating remains the same.
 

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Cornerstone Medical Practice 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. 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. New patient health checks were always undertaken, and 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, and staff used systems to identify and recall patients requiring monitoring, follow-up and review. 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. 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. The practice working proactively with Salford Primary Care Network (PCN) to improve and screening uptake and disease prevention. Clinical records we saw demonstrated that overall care was provided in line with current guidance, although clinical searches undertaken during the assessment identified some individual patient records requiring review. These patients were followed up by the practice immediately following the inspection. However, clinical searches identified some exceptions where continuity of care required strengthening, particularly relating to patients who required follow-ups or who did not receive documented reviews, for example some patients did not receive documented asthma reviews following exacerbations. Following the inspection, the practice were reviewing actions they could take to address this.
 

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.
 

Cornerstone Medical 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 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.
The practice did not meet national targets for screening and immunisations, however the practice worked with its PCN and wider multidisciplinary teams to improve uptake of preventative health interventions, particularly cervical and breast screening, and demonstrated a proactive approach to identifying and supporting patients who did not attend appointments.
 

Cornerstone Medical Practice did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.
Staff understood legislation relating to consent. However, capacity and consent were not always clearly recorded. Concerns identified regarding Do not attempt cardiopulmonary resuscitation (DNACPR) governance, and the practice was unable to demonstrate effective oversight of patients subject to DNACPR decisions. Therefore, there was limited assurance that DNACPR decisions were consistently reviewed and governed. However, following the inspection, the provider shared actions taken to improve this process.