Oakwood Surgery

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 requires improvement. At this assessment, the rating improved to good.

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.

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. Results from the National GP Patient Survey showed people felt involved in assessments of their needs, with 83% of people saying they were involved as much as they want to be in decisions about their care and treatment during their last GP appointment which is slightly lower than the national average of 91%. Feedback we received from people confirmed they felt confident 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. Reception staff we spoke with gave examples of people they were familiar with and ways they assisted such as giving them a quiet place to wait (if a patient needed this due to neurodiversity) or providing leaflets and information to signpost to other services.

The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them

The remote clinical searches we undertook of the service’s clinical records system included reviewing the monitoring of people with long-term conditions to assess if National Institute for Health and Care Excellence (NICE) recommendations were followed. We identified care was not always delivered based on evidence based practice as we saw gaps in monitoring people. For example, we identified the clinical management of asthma needed improvement where people had been prescribed 2 or more courses of rescue steroids. The provider took immediate action to review and update their policy in relation to this and communicated the change to all staff.

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.

The service worked with other services to ensure continuity of care. Staff engaged in regular multi-disciplinary team (MDT) meetings with mental health, frailty, as well as children and young people teams.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The managers shared with us how the staff team utilise systems to communicate updates to all staff.

The service worked with other services to ensure continuity of care, including where clinical tasks were referred 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 supported national priorities and initiatives to improve population health. For example, the service provided information to people on healthy eating, including how to manage diabetes safely while fasting at Ramadan. The service also operated a weight management clinic and smoking cessation.

Staff focussed on identifying risks to people’ health, including those in the last 12 months of their lives, people at risk of developing a long-term condition and those with caring responsibilities.

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.

We reviewed the service’s performance data for childhood immunisations. The World Health Organisation (WHO) recommends a rate of 95% for all routine childhood vaccinations. At our last inspection we found a poor uptake by people of preventative treatments and screening procedures. This was particularly in the areas of childhood immunisations and cervical screening. At this inspection we found the overall vaccination rates had improved since our last inspection however, they continued to not meet this target for childhood immunisations.

We discussed childhood immunisations with the management team who recognised the uptake across all of the vaccinations was on average 84%, which was below the expected standard of 95%. The service continued to promote childhood immunisation through proactive recall processes, opportunistic discussions during consultations, and engagement with parents and carers to address any concerns and improve vaccine uptake. They did this by sharing information in multiple languages and encouraging parents to raise and discuss any concerns they might have.

In addition to childhood immunisation data, we reviewed published national data for the uptake of cervical screening which identified the service was not achieving the national target of 80%. Cervical screening coverage was below the expected 80% target in both eligible cohorts. Uptake was 56% among women aged 25 to 49 years (screened within 3.5 years) and 74% among women aged 50 to 64 years (screened within 5.5 years). The service was actively working to improve participation through recall systems, patient engagement, and opportunistic promotion of cervical screening during routine contacts.

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. We reviewed staff training and saw that all staff had completed training in consent and mental capacity.

Our review of clinical records showed capacity and consent were clearly recorded and documented appropriately. We saw evidence that staff and family members were included in decisions about care where people lacked capacity.

Staff we spoke with understood Gillick competency, which is a UK legal principle used to determine if a child under 16 can consent to medical treatment or make independent decisions without parental knowledge or permission. The service had a process to ensure young adults had control over their own privacy and the amount of parental involvement in managing their care and support.

Do not attempt cardiopulmonary resuscitation (DNACPR) and palliative care decisions were appropriate and were made in line with relevant legislation.