Middleton Health Centre

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

At our last assessment, we rated this key question as outstanding. At this assessment, the rating has changed.

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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.
Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care. The practice adopted a focused, patient-centred approach to care and carried out comprehensive needs assessments, particularly for patients experiencing a crisis. It provided direct health, social, and welfare support where appropriate, rather than routinely signposting patients to other services.
The provider demonstrated a strong understanding of the diverse needs of the practice population and took a holistic approach to people's care. They recognised that when social factors impacted an individual's health and wellbeing, support from a nurse or doctor was not always the most appropriate intervention. Instead, assistance could often be better provided by the focused care worker, who was equipped to address wider social needs. The focused care worker worked closely alongside the clinical team, ensuring coordinated and person-centred support, particularly for individuals with multiple healthcare needs, helping to deliver the right care from the right professional at the right time.
 

The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.
The practice demonstrated a strong commitment to addressing health inequalities and improving access to care for more deprived communities by developing and implementing a range of additional services and targeted initiatives. These included the introduction of dedicated Women's Health and Long-Acting Reversible Contraception services, alongside extensive work to support transgender patients through tailored and inclusive healthcare provision. Care pathways were proactively designed to address patients’ social, mental and physical health needs and the practice worked holistically between the reception staff, clinical team and focused care workers as well as partner organisations. Examples of this include the dedicated Recoffery Support Group. The practice also delivered a variety of awareness-raising events aimed at promoting health education and community engagement. Safeguarding was embedded throughout the organisation, with staff demonstrating a clear understanding of their responsibilities and maintaining a strong focus on identifying and supporting vulnerable individuals. This proactive and inclusive approach helped to ensure that services were responsive to the needs of the local population and those who may be at greater risk of experiencing poorer health outcomes. We saw the practice worked in partnership with other services to meet the needs of its patient population. The practice had tailored its services to meet the diverse needs of its community, for example, building relationships with community groups such as the LGBTQ+ Community to promote the take up of health and screening programmes. There were established mechanisms for engaging with the community and the wider PCN.
 

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
Information to promote the take up of screening and immunisation programmes was available in a range of languages. The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard. Patients were informed as to how to access their care records. Patient information leaflets and notices were prominently displayed throughout the patient waiting area, providing details of a range of local and national support groups, voluntary organisations, and community services available to patients. These resources covered a variety of health and wellbeing needs, helping patients access appropriate advice, guidance, and additional support beyond the services provided by the practice. Staff were able to direct patients to relevant services where appropriate, and information was regularly reviewed to help ensure it remained current and accessible. In addition, the practice website contained information about support groups and external organisations, enabling patients and carers to access this information at a time and in a way that suited their individual needs. This helped to promote patient awareness of the wider support available within the community and encouraged patients to access services that could improve their health, wellbeing, and overall quality of life.
 

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.
We saw that complaints were managed in line with the practice's policy and were appropriately investigated and responded to. We saw evidence that when issues arose with care and treatment, patients were informed promptly. They received appropriate support, honest and transparent information, a written apology, and details of any actions taken to improve processes and reduce the risk of a similar incident occurring in the future. Patients were also offered a face-to-face meeting to discuss where required. The practice also carried out a comprehensive review of significant events. We examined safety records, incident reports, patient safety alerts, and minutes from meetings where these matters were discussed and reviewed, and relevant learning and intervention was put in place where required.
 

The service made sure that people could access the care, support and treatment they needed when they needed it.
The practice had taken steps to ensure the premises were accessible, safe, and suitable for patients with a range of needs. All treatment and consultation rooms were located on the same level, reducing barriers to access, and lift access was available within the main shopping centre. An automatic entrance door had also been installed to support patients and those requiring easier access to the building. In addition, a security gate had been installed next to the reception area to enhance safety and security within the waiting room, helping to protect both patients and staff while maintaining a welcoming environment. The current GP patient survey results showed that 63% were offered a choice of time or day when they last tried to make a general practice appointment, in comparison to the national average of 57%. The practice tailored its services to meet the individual needs of patients, including those with learning disabilities and others who required additional support. Longer appointments were available where necessary. Patients were able to access services in a way that best suited their needs and preferences, including online, via telephone in person at the practice. There were disabled facilities, a private room for breast feeding and a hearing loop installed. This flexible approach helped to promote equitable access to care and ensured that patients received appropriate support in a manner that was accessible and convenient for them.
 

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.
Feedback provided by people using the service, both to the provider as well as to CQC, was positive. Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet.
 

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.
Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. This information was shared with other services when necessary.