The Glebe Family Practice

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

People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. 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 took decisions in people’s best interests where they did not have capacity.

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 has changed to good.

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, well-being and communication needs with them.

Feedback from people using the service was positive. People felt involved in any assessment of their needs and felt confident that 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. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and well-being. 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. 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.

There were effective systems in place to follow up with patients requiring monitoring. For example, patients who missed their monitoring test or review appointments or patients who had not responded to the practice’s requests to schedule an appointment.

The practice had an effective system for receiving, sharing and acting on safety alerts. Staff we spoke with understood how to process these alerts.

Staff worked effectively across teams and services to support people. 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 when clinical tasks were delegated to other services.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. A representative from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical and non-clinical issues. Staff felt there was an open culture, and that safety was a priority. The provider had processes for staff to report incidents, near misses and safety events. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that improved care for others. Staff were able to provide examples of recent incidents, as well as the learning that took place to improve care. Staff knew how to find the incident reporting policy and were able to direct patients to enable them to make a complaint.

Staff told us they routinely monitored people’s care, booking follow up consultations and requesting additional interventions such as blood tests to continuously improve people’s health outcomes.

Childhood immunisations were administered according to the national childhood vaccination programme. Unverified data from the practice showed they were achieving above the national target of 90% (unverified data refers to data that has been provided by the practice and has not been published, therefore has not been verified by the data owner, for example, UK Health Security Agency, NHS Digital, NHS England and Improvement).

Data from NHS Digital - Cervical Screening Programme Coverage Statistics, showed the practice were achieving above the national target of 80% for cervical cancer screening.

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 were appropriate and were made in line with relevant legislation.