Killamarsh Medical Practice

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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 Good. At this assessment, the rating remains the same.

This service scored 79 (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.

There were systems in place 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. 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. Staff could refer people with social needs, such as those experiencing social isolation or dementia to a social prescriber.

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. For example, the management of people with asthma or diabetes.

The service worked very 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. For example, the care co-ordinator worked with several agencies, such as the Derbyshire Carers Association, Dementia Support Workers and the Citizens Advice Bureau to support and co-ordinate the care provided to people with dementia and their carers. Feedback from 2 care homes where the practice provided care and treatment was positive about how the practice worked with them. They told us the weekly ward rounds provided continuity of care for people living in the homes.

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, for example the Primary Care Network.

Staff feedback was overwhelmingly positive about how teams and different staff groups worked together to provide care and treatment. Many staff identified team working within the practice as one of the things the practice did very well.

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 monitored all people’s care and treatment to continuously improve it. Outcomes for people were positive, consistent and screening indicators regularly exceeded national expectations. Nursing staff closely monitored screening outcomes and had identified that breast screening uptake rates in 2022 had fallen. They spoke with people who told them that since the mobile breast scanner no longer attended Killamarsh, they had been unable to attend for screening due to transport restrictions. One of the practice nurses successfully challenged this decision which resulted in the scanner returning to Killamarsh Leisure Centre every 6 months. This improved breast screening uptake rates for 2023/24 to 83% which was above the national average of 70%.

The practice met or exceeded national targets for childhood immunisations and cervical screening. Five out of the 5 indicators for childhood immunisations showed that the practice had met the 95% WHO based target, 2 of which had achieved 100%. There was a highly effective recall system in place to recall people who failed to attend for cervical screening. The practice nurses also provided enhanced late-night clinics to enable working aged people to attend their screening outside of normal working hours. As a result of these systems the practice’s cervical screening rate for people aged 50 to 64 year was 85% and 82% for people aged 25 to 49 years. These were above the national target of 80%.

From the clinical notes we reviewed, we found that people who used the service experienced positive outcomes as set out in legislation, standards, and evidence-based clinical guidance.

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 we reviewed were appropriate and were made in line with relevant legislation.