The Green Surgery Also known as The Green & Fir Road Surgeries

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 good. At this assessment, the rating remains the same.

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 explained that the reviews went beyond clinical checks to look at each person’s wider wellbeing, making the discussions meaningful and personalised. They also provided education and information to these patients regarding diet and exercise to try and reduce the chances of them fully developing or slowing down the development of diabetes. Feedback from people using the service was positive. People told us that they felt involved in any assessment of their needs and felt confident that staff understood their individual needs. Feedback from the NHS Friends and Family Test included comments such as people saying they were “made to feel at ease, listened to, and had information explained clearly,” and that staff “answered all my questions and made sure I understood my care.”

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 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. Staff told us they maintained their professional knowledge through regular revalidation and attending clinical meetings. They added that the team routinely shared information, used meeting time and a multimedia messaging group to discuss new developments, helping ensure care remained current and person‑centred. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. The practice was signed up to receive safety alerts and received updates from CQC and NHS England. Clinical records we saw demonstrated care was provided in line with current guidance.

The service worked well across teams and services to support people. The practice worked with other services such as community services, and voluntary organisations to ensure continuity of care, including where clinical tasks were delegated to other services. Staff told us they had attended multidisciplinary meetings, such as Proactive Anticipatory Care (PAC), which were designed to prevent crises, reduce hospital admissions, and help people remain independent at home. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. For example, information noted in patient’s records could be accessed by the community nursing team and the local hospital and vice versa.

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. Staff reported they supported smoking cessation and weight management initiatives by advising patients and making referrals where appropriate. For weight management, they offered advice and made referrals, including prescribing weight‑related treatment when suitable.

The service monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. The service was below some national targets, such as immunisation rates, there was evidence that the practice had been proactive in encouraging patients to attend screening programmes. They had established systems to monitor non‑attendance for both immunisation and screening appointments. A dedicated administrative team oversaw cervical screening recalls. This ensured tracking and following up with non‑attenders. A similar process was used for immunisations. The administrative team made multiple attempts to contact patients by phone and in writing. 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. All staff had completed mental capacity training. Staff reported that they were encouraged to seek support from a clinician whenever they required additional guidance. 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.