Hurley Clinic

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 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. However, patient feedback suggested people did not always feel involved in the assessment of their needs and their clinicians did not have all the information they needed about them. The service was also performing below the national targets for cervical screening. At our last inspection, we rated this key question as requires improvement. At this inspection, the rating has changed to good.

This service scored 71 (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 we spoke with demonstrated they were aware of the needs of the local community. 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. Staff could refer people with social needs, such as those experiencing financial difficulties, to a social prescriber. The support available included access to an advisor from the Department for Work and Pensions who attended the practice fortnightly. However, patient feedback suggested people did not always feel involved in the assessment of their needs and their clinicians did not have all the information they needed about them.
 

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. We found that 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.

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. Staff had access to information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services. For example, clinical staff participated in regular multi-disciplinary meetings to discuss the needs of their patients. Staff we spoke to told us that leaders were approachable and engaged in clear communication across teams, including through regular team meetings.

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.

The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.
The practice did not meet the national targets for cervical cancer screening, with 47% of eligible patients undergoing screening (National target 80%). However, the service had taken steps to address this low uptake, including by contacting patients to advise them of the benefits of screening. A form was also provided to patients who wished to opt which would then be added to their clinical records. We saw evidence the service monitored the impact of this improvement activity. They provided unverified data which suggested uptake of screening had increased.
The service had also not met the national targets for childhood immunisations. However, we found uptake had improved since the last inspection. An action plan had been implemented to further improve results, which included an information video for parents and easier access to appointments.
We found the service had effective systems in place to monitor long-term conditions and the management of high-risk medicines.
 

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.