Wrenbury Medical Practice

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

People were truly respected and valued as individuals and this was reflected in more than 650 responses shared directly with the Care Quality Commission (CQC). We found that people were supported as partners in their care by a service described as exceptional and second to none. Staff consistently treated people with kindness, empathy, and compassion, while ensuring their privacy and dignity were always upheld. People’s wishes and choices were fully understood, and every effort was made to honour these, enabling them to live as independently and fully as possible.

The culture of the whole team and every member of staff without exception was strongly patient centred and demonstrated how they valued their work, their colleagues, their leaders and their environment which empowered them to provide a high quality and caring service to people. Feedback consistently described the service and its staff as exceptionally kind, considerate, and empathetic.

This service scored 90 (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 was exceptional in treating people with kindness, empathy, and compassion. Feedback from those who used the service was overwhelmingly positive, consistently highlighting the respectful and compassionate approach of staff. Patients also reported that their privacy and dignity were well maintained throughout their interactions with the practice.

Over a 12-month period, the practice gathered Friends and Family Test data, which consistently reflected high levels of patient satisfaction. This feedback was shared with staff each month during protected learning time (PLT), reinforcing good practice. Importantly, the practice also placed strong emphasis on addressing the small number of negative comments received. Each of these was carefully reviewed, discussed, and used as an opportunity for learning and improvement, reflecting the practice’s commitment to continuous quality enhancement.

Results from the National GP Patient Survey surpassed both local and national averages. Notably, 96% of patients said the healthcare professional treated them with care and concern, compared with the local average of 87% and the national average of 85%. Similarly, 96% felt the healthcare professional was good at listening to them during their last appointment, exceeding the local average of 88% and the national average of 87%.

Reception staff were observed to respect patients' privacy and dignity at all times. Staff across the practice demonstrated understanding and a non-judgmental attitude, providing patients with timely, clear information about their care, treatment, or condition. Where language barriers existed, interpretation services were made available, and longer appointments were offered when needed. Additionally, measures were in place to maintain confidentiality in the reception area for example, distressed patients or those requesting privacy were offered a separate space to speak confidentially with staff.

More than 650 patients who shared their experiences of the service directly with the Care Quality Commission (CQC) gave exceptionally positive feedback about the staff. Comments included praises such as efficient, friendly, kind, extremely inclusive, and helpful, evidencing the compassionate culture at the heart of the service.

All practice staff, without exception, demonstrated that patient care was person-centred. The service treated people as individuals and ensured their care, support and treatment met their needs and preferences. People’s individual needs and equality characteristics were understood, and services were adapted accordingly. This was evident from the partnerships that had been established and the positive feedback received by CQC from those partner organisations.

All patients on the Dementia Register received an annual review, providing an opportunity to establish or update care plans. Extended appointments helped ensure individual needs were met. The practice worked with the Social Prescriber, and several other local support networks to support both patients and carers.

98% of people responding to the National GP Patient Survey felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment. This exceeded both the local and national averages of 92%.

The practice was accredited as Veteran Friendly and had proactively identified patients with a military background to raise awareness of available support services. They had built strong relationships with the Traveller community, who had previously found it difficult to engage with NHS services. Their involvement in a project, to improve access for the Traveller community, received positive feedback and was later shared as best practice in a Cheshire-wide online seminar.

Carers were identified and supported, with appointment flexibility to accommodate their caring responsibilities. A Social Prescriber worked in the practice weekly and provided valuable non-clinical support. This led to positive outcomes for patients with complex needs, including those experiencing homelessness. Adjustments were made for patients with hearing impairments such as alerts for lip-reading requirements, to support inclusive communication.

Patients on the Learning Disability Register received extended annual reviews and tailored appointment times. All reviews were undertaken by a GP of the patient/relative’s choice and all were 30 minutes long. Appointments were provided at an appropriate time suit the patient. All patients on the register had attended and received a review at the time of our site visit, with the exception of one who had declined. The practice also maintained a close working relationship with the Macmillan Nurse to deliver coordinated end-of-life care under the Gold Standards Framework.100% of patients on the register had received an annual review at the time of our assessment. 100% of patients had a care plan in place.

Due to the practice’s proximity to canals and marinas, they supported a transient patient population and encouraged engagement with services. The practice demonstrated how this cohort of patients received better outcomes due to collaborative working with them and the community teams specifically enabling them to remain in their preferred environments when nearing the end of their lives.

Patients diagnosed with cancer were routinely offered follow-up GP consultations and referred to the Social Prescriber. The average time between diagnosis and appointment was 15 days and 25% were seen on the day of diagnosis.

The service promoted people’s independence, choice and decision-making so that people had control over their own care, treatment and wellbeing. Staff were able to help patients and their carers to access advocacy and community based services.

The result of the National GP patient survey showed that 98% of patients felt that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment compared with the local and national averages of 92% and 91%, respectively.

Patient feedback was continuously positive about their involvement in decisions about care and treatment. 97%felt their needs were met during their last general practice appointment compared with the local and national averages of 90% and 91%, respectively. 83% said they had enough support from local services or organisations compared with 69% and 68%, respectively.

The practice messaging service was used to follow up with information on the Mental Health Crisis Helpline and Talking Therapies. Patients who had contacted the Crisis Team were proactively followed up by the practice to offer further support if they wished to accept it.

It was demonstrated during the site visit and overall that the service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. There was a system for appointment triage that ensured people with immediate needs had access to services. A duty doctor was available each day to support nonclinical staff in care navigation.

Staff could offer a range of alternatives to patients to meet their immediate needs including emergency support, and access to mental health crisis teams. People’s needs were usually managed on the day of contact with the service. The remaining were either signposted or offered an appointment in the future to meet their needs rather than having to call back. People were directed to the most appropriate person or service to meet their needs and ensure continuity of care where required.

Members of the team had been provided with training on care navigation and in basic life support including the signs and symptoms of sepsis. Staff carried out reviews and monitoring for people and altered their medicines when necessary to meet their changing needs. Leaders had reviewed staffing to ensure there were more than enough clinicians to meet the needs of people.

The practice could initiate insulin to diabetic patients which improved response times for treatment. They could also prescribe, under the Shared Care Agreements in place, attention deficit/hyperactivity disorder (ADHD) medicinesand had forged relationships with the Family Hub Team. This was a Cheshire-based support mechanism run by an experienced Health Visiting team to support parents about such things as ADHD, advice and prescribing of ADHD medicines, sleep, behaviour concerns and diet. An on-site dispensary was also well used by the community.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. Staff told us, without exception, that they were valued by leaders. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas.

Staff reported being supported if they were struggling at work and responded in questionnaires about how their work/life balance had been adjusted when necessary. This had been done in a way that supported them without impacting on other members of the team.

We saw evidence during the last 12 months where leaders had provided presentations, discussions and wellbeing sessions for staff on at least 3 occasions during PLT. We saw that encouragement and praise was given to staff during those sessions and staff reported without exception how this was reflected throughout their working environment. Yoga and deep breathing sessions had been presented by the partners during monthly learning events.

We saw that time was laid aside to ensure staff had the information and resources they required to enable them for the good of their patients. We saw how leaders made staff feel valued, relaxed and included as part of a whole team that worked together to provide an excellent service to their patient community. Leaders demonstrated the systems they had in place to support staff and staff reported without exception how their views and feedback were listened to, carefully considered and used to drive change.