Thorneloe Lodge Surgery

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• 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 asgood.At this assessment, the ratingremainsthe same.

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.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

The practice 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. Meetings were held to ensure staff were updated with the latest information, guidance and changes within the practice.

The clinical searches showed the monitoring of people with long-term conditions was mostly followed in line with National Institute for Health and Care Excellence (NICE) recommendations. For example, one of our clinical record searches reviewed the number of patients with asthma who had been prescribed two or more courses of rescue steroids in the last 12 months. We identified a total of 51 patients and reviewed a random sample of 5 patient records. Three out of the 5 patients had not received consistent follow up appointments to check their response to the treatment.In response to our feedback, the provider has introduced weekly searches to ensure that all patients were monitored appropriately.

We reviewed monitoring of people with hypothyroidism (when the thyroid gland does not produce enough thyroid hormone that can lead to tiredness and weight gain). A total of 533 patients were identified, of which the search identified 8 who were potentially overdue their monitoring. We reviewed a random sample of 5 patient records. Of these 5 patient records, 1 patient was overdue their thyroid monitoring. However, we saw evidence of the practice contacting this patient to arrange a review, but this patient had not responded. The practice had since updated their protocol to ensure a more robust formal escalation protocol for non-responders to encourage patients to attend their medication review in line with the best interests of the patient.

We reviewed patients with chronic kidney disease (CKD) stages 4 or 5. A total of 58 patients were identified, and all patients had the appropriate blood test monitoring in the last 9 months.

We reviewed 5 patients who had very high blood levels of their long-term diabetes monitoring. Of these 5 patients, we found all but 1 patient had received the appropriate care, in line with legislation and current evidence-based good practice. The 1 patient had not had their annual medication review. We discussed our findings with the practice, and they took action to address this.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Findings from the clinical search records indicated that the practice routinely monitored people’s care and treatment to improve and ensure that both clinical and people’s expectations were met.At the time of our assessment, the latest published information from the UK Health Security Agency (UKHSA) showed that the practice exceeded the World Health Organisation target of95% for the number of children immunised against various infectious childhood diseases. The latest published information from NHS Digital showed the practice’s uptake for cervical cancer screening for women was below the 80% national target. Women aged 25 to 49 years old was observed at 73.5% and women aged 50 to 64 years old was observed as 74.3%. Leaders told us they actively engaged with patients to increase the uptake. For example, they sent reminder invites to those who were overdue, offered later appointments and Saturday appointments to increase accessibility. The provider also had procedures in place to contact patients who did not attend their appointment.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.