Middleton Lodge Practice

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination. At our last assessment we rated this key question good. At this assessment the rating remains the same. This meant people’s needs were met through good organisation and delivery.

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 were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The service recognised the diverse population needs and fully understood their service’s demographic and language barriers. For example, translators were utilised to assist with telephone consultations where required.

Our review of clinical records showed people were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care. The nurse also told us that would always provide advice to people to come back if their condition worsens.

Accessible standards and barriers to care were considered for people, with alerts added to medical records so that reception were aware upon contact that the person had additional needs. For example, people who were blind or hard of hearing were collected from the waiting room by the clinicians, a hearing loop was installed at reception. People with autism or a learning disability were offered a quiet place to wait for appointments.

The service reached out to people with learning disabilities and their carers and encouraged them to accept an invite for a learning disability health check.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service had access to interpreter and translation services, including British Sign Language. Information about the need to book for an interpreter was recorded on people’s records and additional time was provided for appointments. Staff told us they had access to services for translating documents into appropriate languages, including into English. A hearing loop was also available. People were informed as to how to access their care records.

A range of health care information, and local support groups were available in the practice and via the practice website. We saw notice boards within the waiting room which communicated information for people. For example, carers and young carers.

Leaders provided information for staff and implemented daily bulletins for general updates and important updates were shared via a chat and messaging system.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff treated people with compassion and understanding. They involved people in decisions about their care and told them what had changed as a result.

We saw complaints were managed in line with the service’s policy. Complaints reviewed showed the practice responded to feedback appropriately, openly and in a non-defensive manner. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback and complaints.

The service made sure that people could access the care, support and treatment they needed when they needed it.

People were offered an appointment appropriate for their assessed need or directed to an alternative service. Staff were able to signpost people to the most appropriate pathways when required. For example, the pharmacy first scheme, social prescribers and health and wellbeing coaches. People were also signposted to the local urgent care centre when appropriate.

People who required routine appointments outside of the usual working hours had access to evening and weekend appointments. These appointments were booked on behalf of people by the service. Housebound people were offered home visits.

The service was able to offer extended appointment durations for people with a learning disability.

National GP Patient Survey data and feedback received from people were positive about the overall experience of contacting the practice. Indicators showed 68.4% of respondents were positive about their overall experience of contacting the practice which was slightly below the national average of 69.6%. In addition, 63.8% of respondents were positive about how easy it was to contact their GP practice on the phone, this was above the national average of 52.9%.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. For example, extended hours appointments for workers, appointments at quiet times for vulnerable people and extended appointment times for complex cases.

The service had processes to ensure people could register at the service, including those in vulnerable circumstances such as homeless people and people from travelling communities.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. The service were proactive in identifying people approaching end of life and sensitive to their needs for advanced care planning.

Records we reviewed showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. This information was shared with other services when necessary. For example, the out of hours services and other health care professionals involved in the care of this group of people.

We were assured that safeguards were in place to ensure that decisions were made which were in the persons’ best interest. When people did not have mental capacity to make their own decisions regarding end-of-life care and priorities for care and treatment. family members and carers were involved in decision making.