St John's Medical Centre

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

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same. We found that staff involved people in decisions about their care and treatment and provided them with advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

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.
Staff told us that people’s individual needs were checked during health reviews. Reception staff used digital flags within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present. The provider had effective systems to identify people with previously undiagnosed conditions.
The practice was aware of the needs of the local community and promoted health initiatives which aimed to improve outcomes for patients with long term conditions including diabetes and chronic kidney disease.
Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.
 

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Staff told us they received updates from managers by email and during regular meetings. Audits were carried out by managers to ensure that these guidelines were followed. Clinical records we saw demonstrated care was provided in line with current guidance.

The service worked well across teams and services to support people. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. Multi-disciplinary meetings were held to discuss cases which included consultants, social workers or health visitors and district nurses. Specialised teams had been introduced, including a referral hub, which ensured staff had oversight when patients were referred between services. Electronic records were also used which could be accessed by other services when needed.

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. This included a substance misuse clinic and a Saturday multi-morbidity clinic.

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. 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 we spoke to demonstrated that they understood and applied legislation relating to consent. Capacity and consent were clearly recorded. We found that do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.