Little London Surgery

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

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 Good. At this assessment, the rating remains the 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.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider ensured patients’ needs were accessed to identify how best to provide care and treatment. Feedback from people using the service was generally positive as to the assessment process.

Staff understood people’s individual and cultural needs. Feedback from people indicated that staff were excellent and went out of their way to support them. We found that staff at reception had access to relevant information to support decision-making and help them identify how best to respond to people when they presented at the reception desk.

We found that people’s care and treatment needs were being reviewed, and this ensured the care and treatment people received was right for them. There was an effective system in place to identify whether people were vulnerable and how best to support them.

There were effective systems to identify people with previously undiagnosed conditions. The provider also had access to a social prescriber to support people who were socially isolated or needed support within the community.

Staff had access to training and development, so they had the right skills to support people. We found that staff had access to appraisals on an annual basis however, non-clinical staff did not have regular supervision to allow them or the provider to share concerns they may have. The provider assured us this would be put in place and before we left the site visit this was being done.

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. Staff we spoke with told us they attended regular team meetings where discussion took place, and they could also approach managers when needed for guidance. We also found that where guidance and legislation changed there was a system in place so all staff could access this information.

We found where people had long-term conditions like chronic kidney disease (CKD) or diabetes that evidence-based care and treatment was an important part of how they received the best care and treatment. This also involved people receiving reviews when needed.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

We found the provider worked with other agencies to provide people with the right level of care and treatment. Staff could access the information they needed to be able to work well between themselves as a team and others.

When the provider worked with other services they ensured continuity of care, including where clinical tasks were delegated to other agencies. This was to make sure that the care and treatment people received was what they expected.

The provider worked with the local Integrated Care Board (ICB), the Primary Care Network (PCN) and other groups within the local community to improve how people’s care and treatment was reviewed.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff focussed on identifying risks to patients’ health, including those in the last 12 months of their lives, patients at risk of developing a long-term condition and those with caring responsibilities. Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity.

Health promotion information was displayed in the reception area and in prominent areas of the premises to support people to live healthier lives.

The provider told us they supported a local food bank as part of their engagement with the community, with the aim of reducing the risk of vulnerable people not having enough to eat. They explained that, in previous years, patients had given gifts at Christmas. This had been adapted so that patients were encouraged to donate food instead, which was then provided to the local food bank. The provider told us that, last Christmas, over a quarter of a tonne of food was donated

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

The practice met national targets for screening and immunisations. Where they had concerns around people not attending screenings or appointments, they had systems in place to manage this. From the clinical notes we reviewed, we found that people who used the service experienced positive outcomes as set out in legislation, standards, and evidence-based clinical guidance.

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.

We reviewed a sample of patients records where Do not attempt cardiopulmonary resuscitation (DNACPR) forms were in place to see how consent was being achieved. We found no concerns with the process followed.