Portsdown Group Practice Also known as Cosham Park House

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. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those important to people and made decisions in people’s best interests where they did not have capacity.

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 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 overall positive. People felt involved in any assessment of their needs and felt confident staff understood their individual and cultural needs. 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 as part of people’s reasonable For example, people with learning disabilities were offered extra appointment times and the service demonstrated people were invited for annual medicine and health reviews to monitor their care and treatment. Staff checked people’s health, care, and wellbeing needs during health reviews.For example, people with learning disabilities were offered extra appointment times and the service demonstrated people were invited for annual medicine and health reviews to monitor their care and treatment. Staff checked people’s health, care, and wellbeing needs during health reviews. The provider reported that, despite a year-on-year increase in the Learning Disability (LD) register size, they have consistently achieved their own target of over 80% for annual reviews, reflecting the positive impact of a personalised recall system and dedicated LD service. For instance, in March 2023 the register totalled 479 with 393 reviews completed (82.05%), in March 2024 there were 535 on the register and 433 reviews (80.93%), and by March 2025 the register had risen to 557 with 461 reviews achieved (82.76%).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. For example, during our review of the service’s clinical records system, we noted Health Action plans were in place on people’s records. This helped ensure they were used consistently and effectively to provide personalised care. The service identified previously undiagnosed conditions, exemplified by a frailty quality improvement project which identified people on multiple medicines and improved their nutritional status. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. Our review of the service’s clinical records system indicated people received care, treatment and support in line with evidence-based guidelines. People with long-term conditions were shown to have been assessed and treated in line with national guidelines, such as people who were diagnosed with chronic kidney disease (CKD). A sample of records reviewed showed people were recalled in line with blood monitoring requirements and medicines were reviewed to ensure care was provided in line with evidence-based guidelines.

Staff were up to date with evidence-based guidance and legislation. The service used clinical audits and carried out regular safety searches to assess compliance and drive quality improvement. For example, the service had undertaken an audit for women under 55 years of age of child-bearing potential to ensure they had a completed an annual risk assessment regarding the medicines they were receiving These audits are crucial for ensuring compliance with safety regulations, such as those from the Medicines and Healthcare products Regulatory Agency (MHRA), to minimise risks associated with these medicines during pregnancy. The service discussed updates where there have been changes of guidance or recent clinical queries as part of daily clinical huddles, clinical coffee breaks and fortnightly clinical meetings. Clinical staff shared examples of discussions on new asthma guidelines and management of liver disease, to ensure staff were able to deliver updated evidence-based care.

The service worked well across teams and other 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 service worked closely with community district nursing teams, social care and mental health teams to collaboratively document joint assessment approaches to people’s care. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The service worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services. For example, urgent tasks were raised to GPs based on information escalated by Out of Hours and NHS 111 services, particularly for people who were required to be seen in-hours by the service based on their symptoms and clinical presentation.

The service always 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 people’s 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. For example, in the reception area there were posters to inform people how to prevent sepsis, strokes and heart attacks. The service was awarded a palliative care certification for implementing drop-in events for carers, which included health checks.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and outcomes met both clinical expectations and the expectations of people themselves. The service had also exceeded the World Health Organisation’s target of 95% uptake for children who had completed a primary course of childhood immunisations.The service also had a programme of regular clinical audits of prescribing focused on improving care and treatment. For example, the service had completed a project for people who had a high risk of chronic kidney disease (CKD) and diabetes. This involved looking at prevention with the alternative prescribing of a new medicine. A target of 60% was set to review all people prescribed and the service achieved a 61% success rate. The senior clinical pharmacist had received the ‘i2i best service implementation’ award. This award recognised the clinical pharmacists who had demonstrated measurable improvements in patient care as a result of the CKD and diabetes work. The service had also undertaken an opiate (pain relief) deprescribing project. As a result, the service was able to ensure opioid medicines were only reissued on a 28-day cycle with an effective monitoring system for the use of them.

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. Our review of 5 records of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) showed decisions were appropriate and made in line with relevant legislation. All clinicians completed annual mental capacity training.