Ashfields Primary Care Centre

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed all the quality statements in this key question. At our last assessment, we rated this key question as good. At this assessment the key question is rated as outstanding. We rated the service as outstanding for the caring key question due to the ways in which the service demonstrated kindness and compassion, person-centred care and promoted people’s choice and independence. People’s individual needs and preferences were understood and reflected in their care, treatment and support. Staff we spoke with or received feedback from demonstrated a caring and patient centred approach to their work. The practice received higher than average scores for patient satisfaction in the National GP patient survey for questions relating to this key question. The provider had arrangements in place to promote staff welfare. Overall, staff felt well supported in their roles.

This service scored 90 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We found evidence of outstanding practice for this quality statement. The provider demonstrated kindness and compassion to patients through the work of the care co-ordinator team whose role was to help patients who may need additional support due to illness or vulnerability such as patients with poor mental health, veterans and asylum seekers. This team provided a direct link to the practice, supported patients with their healthcare and provided information to support their health and well-being. The provider had received the Employer Recognition Gold Award for services and work with the military, veterans, reservists and families. The practice had been invited to work alongside NHS Employers and other practices to be a mentor as a result of this recognition. Charity events were held which supported local services such as a food bank, cancer care and animal rescue. The care coordinator team also promoted a donation of clothing and toy event to support local asylum-seeking families. The provider met with a local charity for young carers to improve take up of services and establish their needs. Feedback from people who used the service was very positive for being treated with kindness, empathy and compassion. The experience of people who used the service as indicated in the National GP Patient survey showed that people felt listened to and were treated with care. For example, 93% of patients (compared to 85% nationally) felt that during their last appointment the healthcare professional was very good or fairly good at treating them with care and concern and 91% of patients (compared to 87% nationally) felt healthcare professionals were good at listening. Staff displayed understanding and a non-judgemental attitude towards people. Staff told us they gave people appropriate and timely information to understand their care, treatment, or condition. There were arrangements to ensure confidentiality and privacy at the service, for example, if people wanted to speak to reception staff in confidence.

The service ensured people’s individual needs and preferences were understood and reflected in their care, treatment and support. Patients’ equality characteristics were understood, and services were provided to meet these. Patient communication needs were identified and met to enable them to be fully involved in their care. For example, Covid and flu vaccination campaigns were advertised through social media, text, poster and letters. Staff had been provided with training in equal opportunities and in identifying and supporting the individual needs of people. For example, staff had received training in meeting the needs of patients with autism, dementia and learning disabilities. Staff we spoke with told us how they ensured the individual communication needs of patients were known and accommodated. For example, a translation service was used to support patients at appointments and to translate health related documentation. Information was available in different formats, for example, easy read, to meet the needs of patients.The provider worked with the LGBTQ+ community, asylum seekers, travellers, boaters, carers and young carers to identify and meet their individual needs. The practice worked with a young carers organisation to obtain information about young carers in the community and what the practice needed to do to meet their needs. The practice also worked with local schools to see if their young carers needed specific support from the practice. The practice had supplied registration cards with information about how to access services to local boaters. They met with representatives the LGBTQ+ to decide on the support they would like from the practice. To support patients with a learning disability small group sessions were held to provide tailored information about breast screening. This prepared people and enabled people to gain a better understanding of the process. Group sessions for people with dementia and their carers were also being run to provide support and advice.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. The result of the National GP patient survey showed that 94% of patients (compared to 91% nationally) felt that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment. Patient feedback shared directly with CQC was also positive about their involvement in decisions about care and treatment. People were supported to digitally access services. The care coordinator team had held sessions for people on accessing the NHS App at a local library. They had introduced a “chat bench” at the practice whereby a patient could get support from a care coordinator by choosing to sit there. The practice promoted services that supported hard to reach groups.The team had worked with local schools to inform young people about access to medical records and confidentiality. They had produced an information guide to support this and they contacted patients between the ages of 13 – 18 annually to ensure they had the people they wanted accessing their medical records recorded in their notes. The practice was a Hate Crime Reporting Centre which gave people more control and choice over where they went to report this. Information sharing events were provided to promote the health and well-being of patients and the provider also attended local community events, such as Pride and Armed Forces Day to provide information about the services offered at the practice and how to access them.

The annual National GP Patient Survey indicated people felt their needs were met, felt listened to, were treated with care and concern and had confidence and trust in the clinicians. Staff and leaders told us how they responded to people’s immediate needs. Training, guidance and standard operating procedures were in place to ensure that patients needs were prioritised and to identify patients who required urgent attention or referral. People’s records reflected how their needs were to be met and indicated people who may need an immediate response from the service, such as patients who were receiving care at the end of their lives. Urgent referrals were followed up to ensure that patients had received an appointment. Care-coordinators provided a direct link to the practice for patients who may need additional support, for example due to illness or vulnerability.

The provider promoted the wellbeing of their staff to enable staff to deliver person-centred care. This included providing the necessary resources and facilities for safe working, such as regular breaks and rest areas. Reasonable adjustments were made to support staff and requests for flexible working were considered. Well-being activities and social events were provided to support staff and promote morale. Staff contributions to the workplace were recognised for long service and staff could be nominated for an award by their colleagues for dedication to the service. A staff newsletter was produced which encouraged staff contributions. Staff development was promoted and staff told us how they had been supported to develop their skills and experience. There were processes for staff to give feedback on how the service operated and we were given examples of changes made as a result of listening to staff. A wellbeing survey was sent to staff on a quarterly basis. There had been a low response rate for the last 3 surveys and the provider was looking at how to increase this. Overall, staff told us they were positive about working at the practice. They felt valued and supported by colleagues and leaders. They felt able to contribute to decision making about how the service operated and that their opinions would be listened to. However, some staff told us improvements could be made to communication between the teams and from the management team and that they would like better recognition for their roles and additional responsibilities. Feedback from the staff surveys also showed some staff felt that improvements could be made as they did not feel able to raise an issue and that the management team were not always approachable.