Albrighton Medical Practice

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 outstanding. At this assessment, the rating has changed to 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 using the service feedback that they felt involved in any assessment and confident that staff understood their individual and cultural needs. Staff were aware of the needs of the local community and 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.

Service users were actively referred to the social prescriber within the Primary Care Network (PCN) when a social need was identified through assessments and interactions. Service users with additional needs were given extra time in appointments to ensure their assessment was meaningful and suitable for them.

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 applied evidence-based approaches to improve outcomes and regularly discussed cases with their clinical supervisor or peers for shared evidence-based practice. Staff had allocated time for learning and development where guidance could be reviewed and discussed. People using the service said they were confident in the staff knowledge and trusted staff to make decisions that were safe and right for their needs.

Staff education sessions were held regularly, attended by various specialist clinical roles such as a respiratory community nurse.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

All staff demonstrated a clear understanding of roles and responsibilities, the flow of work processes was clear and the staff worked well together. Staff were able to explain the full process of work streams, with many staff having dual roles or training in other areas to provide support during team absence ensuring continuity. The services encouraged development and actively supported additional roles through the PCN such as a social prescriber and mental health practitioner.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The service worked with other services to ensure continuity of care, including where clinical tasks were delegated to other

Leaders and staff worked collaboratively with colleagues in the local PCN to address the needs of the patient population. The service contributed to shared learning by delivering an information session focused on improving outcomes through cancer audits and supporting the dissemination of best practice across the network.

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.

Results from the National Patient Survey results demonstrated that 86% of people had enough support from local services or organisations in the last 12 months to help manage their long-term conditions or illnesses. This was significantly above the national (69%) and local (72%) averages.

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 stop smoking and tackling obesity.

Staff actively signposted and referred people to various services available with the PCN such as a social prescriber and a mental health practitioner as well as local initiatives and groups.

There were facilities for service users to monitor their own weight and blood pressure within the premises to empower involvement in their own health monitoring if they wished. There was a good range of information available relating to different medical conditions and support groups locally and nationally for informed decisions.

The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The service met national targets for screening and immunisations. From the clinical searches completed, we found that people who used the service generally experienced positive outcomes as set out in legislation, standards, and evidence-based clinical guidance. For example those service users taking the medicine Valproate, which can be taken to treat seizures, received additional information and support relating to contraception and an annual review.

There were some gaps identified during the clinical searches we performed, such as overdue medicine reviews for those service users prescribed more than ten different medicines and exacerbation of asthma reviews after steroid treatment, though records show service users were safety netted.

We were told safety alerts were shared but there was no documented evidence of sharing, actions completed and assurance that all the relevant staff members were aware and understood. Clinical searches identified some gaps in safety alert actions, such as the day of the week added to prescriptions to avoid incorrect dosage for drugs that are taken once weekly. Following the site visit, the service completed an assessment of all patient safety alerts currently in place and confirmed that all required actions were being taken. They provided evidence to demonstrate that a process had been implemented to ensure safety alerts are managed effectively going forward

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. Chaperones were available upon request with information of this displayed in clinical rooms. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were clinically appropriate, however we found gaps in the recording of the decisions and documentation electronically. The service demonstrated a caring and holistic approach to palliative care and end of life care. The service didn’t always have the information regarding cardiopulmonary resuscitation clearly documented within patients electronic records, this had already been identified by the service leaders, with a case study, audit and actions agreed which were being completed when the assessment took place.

People who used the service felt they could make an informed decision about their care and treatment because they had been provided with the information, they needed to support them to do so. The National GP patient survey showed that 97% of respondents stated that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment. This was above the national (91%) and local (92%) averages.