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

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 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 were at the centre of their care and treatment choices. The practice worked in partnership with other organisations to decide how best to respond to any relevant changes in patient’s needs.There was a patient participation group (PPG) in place, however, it had not been meeting regularly. Representative from the PPG described how the practice involved them, for example, in setting up a baby clinic, and discussed improvements such as better timing for appointment access. Our review of clinical records showed patients were supported to understand their condition. They were also involved in decisions about their care. Clinicians recorded discussions and consent to demonstrate this.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Leaders explained they met regularly with multi-agency staff to discuss and improve outcomes for people with complex needs. Staff reported that the practice participated proactively in Proactive Anticipatory Care (PAC) multidisciplinary meetings, which partners attended weekly. These meetings focused particularly on frail and elderly patients, helping to keep them well and reduce hospital admissions, while enabling the team to review patients’ progress and maintain consistent communication with partner organisations involved in their care.

Staff also reported that the practice had good working relationships with maternity services, district nurses and the social prescriber. Patients could book appointments by telephone or walking in longer appointments were offered to those with more complex needs. There were established mechanisms for engaging with the community healthcare provider. Staff reported that their approach had been to ask, listen, and tailor care accordingly, ensuring patients felt respected and fully involved in decisions about their health.

The service supplied up-to-date information in formats that were tailored to individual needs. Feedback from theNational GP Patient Survey showed that 93% of patients felt the healthcare professional they saw had all the information they needed about them during their last appointment, which was in line with the local and national averages of 93% and 92%, respectively. Information to promote the take up of screening programmes was available in a range of languages. The practice had access to interpreter services, including British Sign Language.

Patients were informed as to how to access their care records. Patient information leaflets and notices were available in the patient waiting area which told patients how to access support groups and organisations.

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

The practice manager was the lead for complaints and carried out the investigations and completed the responses. We examined a sample of complaints and found all had been managed satisfactorily and in a timely manner. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints. From our review of the meeting minutes and conversations held with staff members, we found that learning from complaints was embedded, and staff were able to identify changes made because of patient feedback.

The service made sure that people could access the care and treatment they needed when they needed it.The main site was fully accessible, with the entire building on 1 level and no steps, making it suitable for patients with mobility difficulties or those using wheelchairs. Although the branch site had two floors and did not have a lift, staff explained that the practice made reasonable adjustments to ensure patients were not disadvantaged. If a patient was unable to access the upstairs consulting rooms, they were offered an appointment in the ground‑floor rooms at the branch site or at the fully accessible main site. People could access the service to suit their needs for example online, in person and by telephone. Staff reported that the service made sure that people could access the care, support and treatment they needed when they needed it. However, during the site visit, it was noted that no hearing loops were available, and some staff were unsure whether the practice had one. This highlighted the need to review accessibility equipment and ensure all staff were aware of the support available for patients with hearing impairments.

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

Feedback provided by people using the service, both to the provider as well as to CQC, was positive. Staff reported that the practice encouraged patients to inform them directly if they were struggling, and they regularly reviewed feedback from sources such as the Friends and Family Test, Google reviews, and verbal comments shared with staff. They also monitored service data to identify any patterns that might indicate barriers to access. For example, a colleague reviewed DNA (Did Not Attend) data on a monthly or quarterly basis to look for trends. Staff reported that they treated people equally and without discrimination. All staff had completed learning disabilities and autism training. They implemented additional support by allotting extra time / double appointment slots with the health care assistant if required. Annual health checks were offered to all patients with a learning disability and autism. Leaders proactively sought ways to address barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities.

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. Patients identified as end of life were discussed at the clinical meetings to ensure a joint up approach to the care they receive. Clinicians followed a clear process for adding patients to the register and for recognising early signs that someone might require end‑of‑life support.

Our records review 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.