Devon Square Surgery

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 in March 2015, we rated this key question as Good. At this assessment, the rating remains unchanged.
 

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 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 evidenced people were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

Clinical records showed that people were helped to understand their conditions and were involved in planning their care. Regular multi-disciplinary meetings ensured person-centred, holistic treatment, with longer appointments provided for those with additional needs, such as learning disabilities or other protected characteristics under the Equality Act 2010. The service collaborated with mental health teams, learning disability nurses, and external agencies to develop co-produced care plans. Social prescribing services connected individuals to community groups and activities, helping them meet personal goals, as demonstrated in case studies.

The service liaised with and involved mental health teams, learning disability nurses and external agencies to co-produce care plans.

The service had access to social prescribing services, who provided people with a non-medical approach to improve health and wellbeing by connecting them to local community groups and activities. We saw case studies of where people had been supported by a social prescriber to meet goals and outcomes of their choice.
 

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

We saw the service worked in partnership with other services to meet the needs of people.

The service had tailored its services to meet the diverse needs of its community. For example, building relationships with community groups to help facilitating of screening programmes. For example, bowel and cervical screening promotion at community events.

We observed that the appointment system allowed people to see the same healthcare professional for continuity of care. Staff worked together across the service to address patient needs. A PPG member said, "I am happy seeing any of my GPs and they always provide continuity where possible."
 

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 service made reasonable adjustments to meet individual needs in line with the Accessible Information Standard.

Adjustments included: easy-read materials, interpreter services including British Sign Language, Interpreter services, translated materials.

The services’ website contained health promotion information, including details on NHS Health Checks, screening programmes, maternity care, and contraception.

People were informed as to how to access their care records.
 

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.

Learning from complaints were evident and staff were able to identify changes made because of feedback from people who use the service. The service monitored complaints and identified themes and trends.

Information on how to provide feedback or make a complaint was clearly displayed on the service website. People could raise concerns in person, in writing, or by email, and those who did were listened to and received a timely response.

Records showed there were clear records maintained of all complaints received, the actions taken and outcomes, being open, honest, and transparent in responses to complaints. Learning from complaints were recorded on a complaint's summary. For example, an alternative clinician consultation on medicines prescribed so that the decision was not limited to a single GP.

Changes were made in response to patient feedback. For example, following feedback from people changes were made to the phone system.

Feedback from the patient participation group (PPG) was positive and they commented how the service is receptive to feedback. For example, such as where the PPG feedback about the services use of acronyms. Additionally, the PPG were supported to make the practice more dementia friendly and had added dementia friendly signs to the entrance and toilet doors; a contrasting toilet seat for improved visibility; contrasting door handle in the waiting room and staff wearing Dementia Friends Trained for easy identification.
 

The service made sure that people could access the care, support, and treatment they needed when they needed it.

People could choose whether they had a face-to-face consultation or a telephone consultation. Patient advisors (reception staff trained in care navigation) guided people on whether a telephone call was likely to not be clinically appropriate. For example, whether a physical examination may be required.

Feedback from members of the community about the provider were positive.

The service offered extended access on Tuesdays from 6:30pm to 8pm, with appointments available face-to-face or by phone with various clinicians based on demand. Through the local primary care hub, extended weekend hours were also available, offering face-to-face, telephone, or online consultations for greater convenience. Information about these services was shared on the website.
 

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their 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 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. Staff treated people equally and without discrimination.

Leaders and staff proactively sought ways to address any barriers to improving people’s experience and worked with local organisations to address any local health inequalities. For example, a social prescriber addressed a lack of local physical activity options for older adults in support provision and worked with Age UK to introduce seated exercise classes in Newton Abbot.

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 service, including those in vulnerable circumstances such as homeless people and Travellers. Staff assisted people in registering for digital access, including offering digital inclusion support and tailored guidance for those less confident with technology. People who wished to register who did not have online access, could contact the service to complete a paper registration form, which was the same as the information submitted via the online portal.

The service could accommodate people with sensory needs to wait in the quieter areas rather than the waiting room. The service considered and always tried to accommodate requests for preferred times of the day to assist those who preferred the quieter times.

We saw that digital flags were added to people’s records to ensure consistent and respectful care for people with specific needs, and who may need reasonable adjustments. For example, learning disabilities, autism, mental health conditions, deafness, and visual impairment.

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.

Staff attended multi-disciplinary meetings to discuss patients receiving end-of-life or complex care. Clinical records were updated to reflect any actions or changes made to their care plans. Our review of clinical records showed people were supported to consider their wishes for their end-of-life care.

Care plans documented a do not attempt cardiopulmonary resuscitation (DNACPR) decision when it had been made (although these were currently part of an ongoing audit). Families and/or carers had been involved in these decisions when the person lacked the capacity to make them independently. This information was shared with other services, such as the out-of-hours services.