Cricklade Surgery

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• 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 requires improvement. At this assessment, the rating remains the same.

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.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

The service still did not plan and deliver people’s care and treatment with them. They still did not follow legislation and current evidence-based good practice and standards.

Out of 16 people were identified as being prescribed 2 or more courses of rescue steroids. We reviewed 5 of these records. Of those, 2 people had experienced an asthma exacerbation and had still not received a follow-up with a clinician in line with NICE guidance, and 1 person had still not received a required asthma review.

Out of the 21 people identified with a potential missed diagnosis of chronic kidney disease (CKD) stages 3, 4 or 5, we reviewed 5 records. Of these, we identified 2 people who were still not receiving appropriate monitoring in line with NICE guidance.

Out of the 32 people diagnosed with diabetes whose latest HbA1c was elevated, we reviewed 5 records. Of these, 2 people were still not receiving appropriate monitoring in line with guidance.

The service had still not ensured people diagnosed with hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone, received appropriate monitoring in line with national guidance. We reviewed records of people with hypothyroidism who had not received thyroid function tests (TFTs) for 18 months. TFTs are blood tests used to monitor thyroid hormone levels and help ensure treatment remains effective and appropriately managed. Of the 5 records we reviewed, 2 people had not received appropriate monitoring. We conducted an enhanced search which identified that, in the preceding 12 months, a further 8 people had not received the necessary monitoring of their thyroid stimulating hormone (TSH) levels in line with NICE guidance.

The service was informed of the findings of the clinical searches on the day the searches were conducted. We requested information from the provider about how the identified people would be followed up. This information was not provided within the deadline given.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

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

Evidence of quality improvement activity was requested of the service as part of this assessment. However, this was not provided. The service did not provide us with evidence to demonstrate how it monitored and improved people’s outcomes.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.