Norton 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

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 Requires Improvement. At this assessment, the rating has changed and is now 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.

People felt involved in any assessment of their needs and felt confident that staff understood their individual needs. Reception staff 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 checked people’s health, care, and wellbeing needs during health reviews. We reviewed evidence which indicated the practice considered additional needs of patients with learning disabilities and provided care which was flexible to meet their needs.

Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. The provider had effective systems to identify people with previously undiagnosed conditions. 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. 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 usually provided in line with current guidance. However we noted the errors in PSD’s, which would indicate the provider had gaps in its clinical review processes.

Documentation completed at care reviews was comprehensive. The practice were in the process of changing the long-term conditions review process which aimed to split reviews into 2 parts. This would mean that patients had appointments in advance, and clinicians had all of the required information before the patient attended the appointment.

The practice did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. This was due to a lack of consistency throughout the departments within the practice. Staff and leaders told us there had been some elements of disagreement around processes, including those that recall patients. Management told us they had decided on a system to use, but staff did not feel this would be effective, whilst leaders assured us a search had been agreed upon, we will re-visit this at our next assessment to ensure leaders and staff have begun working in an aligned manner.

Staff had access to the 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.

The practice 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. The practice had an established nursing team at the time of our assessment, who supported patients with long term conditions such as diabetes and Asthma.

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 practice had access to a frailty nurse, and a social prescriber via the Primary Care Network (PCN).

The practice routinely monitored people’s care and treatment to continuously improve it. We saw evidence of results being actioned appropriately. The practice had not met the national target of 80% for cervical screening. For women aged 25-49 the practice were at 77% and for women aged 50-64 the practice had achieved 76%. Most childhood immunisations were within the national target guidance; Measles Mumps and Rubella vaccinations were just below the 90% target at 88%. There was a policy and process in place for patients who did not attend these appointments.

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. Documentation was clear and comprehensive for patients, and we reviewed evidence which indicated patients were coded correctly.

Furthermore we reviewed evidence of clinical audits that considered antibiotic prescribing. We saw evidence of review for patients prescribed Nitrofurantoin on repeat, and a recall process had been implemented. The audit showed that all patients who required a blood test in relation to this medication had received one.

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. Staff were aware of power of attorney and patients were coded correctly. We reviewed evidence of all training relating to capacity and consent being up to date. Capacity and consent were clearly recorded. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation. We noted an improvement in policy around DNACPR’s since our last assessment.