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Archived: HT Practice Good

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All reports

Inspection report

Date of Inspection: 12 December 2013
Date of Publication: 22 January 2014
Inspection Report published 22 January 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 12 December 2013, talked with people who use the service and talked with staff. We reviewed information given to us by the provider.

Our judgement

Patient's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Reasons for our judgement

On the day of our inspection the main computer system for the practice had ‘crashed’ and because of this we were unable to access patient’s records. However we were able to review hand written records along with other records which detailed what treatments and plans of care had been discussed with patients during the day and we spoke with six patients of the practice.

Patient’s told us they were given good information about their treatments by GPs. They told us GPs had explained the treatment to them and if they needed to be referred to see a consultant. Patients told us they felt involved and they were consulted about their treatment.

Another patient told us they were happy with the consultation that had taken place in respect of their child. They told us they felt the doctor had listened to them and had also spoken with their child. They knew what treatment was planned and this involved a referral to a consultant for specialist treatment.

The majority of patients we spoke with were unsure as to who was their registered GP. This was because historically other practices in the locality had merged and these GPs had joined the practice and had since retired. Patients told us not knowing who their named GP was, wasn’t a problem as they were always seen. We asked the practice manager about this and how patients could be informed of who their registered GP was. They told us that previously it had been the responsibility of the Primary Care Trust (PCT) to inform patients. It was unclear if this would be the role of the local Clinical Commissioning Group who had taken over from PCT’s. The registered provider may wish to consider how patients’ could be informed of their registered GP.

We saw that when a patient first registered with the practice they were invited to attend a health screen with a healthcare assistant and then after patients could make an appointment with a doctor should they need to. We saw that healthcare screens were comprehensive and included BP tests, weight and height measurements, consideration of smoking and alcohol intake along with family medical history. We spoke with a new patient before and after their health screen. They told us; “it was good. I can see the doctor now.”

We saw that both the healthcare assistant and practice nurses provided a number of health promotion clinics including smoking cessation and a number of chronic diseases clinics including COPD and heart disease. We saw patient recall systems were in place for patients with chronic health conditions who were recalled for ongoing monitoring of their condition. We spoke with one patient who told us they attended the practice for regular reviews of their medical condition. They described the service they received as ‘Brilliant’ and said: “The nurses are fantastic, they [staff] makes you feel so comfy.”

We found that there were other arrangements in place to monitor patient care and treatment. The practice used ‘Telehealth’ which monitored specific chronic health conditions such as heart disease and hypertension. We were told that patients had a self-management plan and provided data to the surgery twice per week. We were told that the system had been beneficial in reducing the number of patient admissions to hospital.

We observed that a number of multidisciplinary health care meetings took place at the practice and these to assured the continued monitoring of patients conditions and treatments, for example monthly Gold Standards Framework meetings which reviewed complex patient cases. This meant that patients could be assured that they received safe and appropriate treatment that met their needs. We attended a patient review meeting on the day of our inspection and saw how collectively GPs, practice nurses and a healthcare assistant all contributed to decision making processes about future patient care. This showed the provider worked with other professionals to ensure the welfare and safety of people who used the service