Henmore Health – Ashbourne Surgery

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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 looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.

This service scored 70 (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 treated people with kindness, empathy and compassion and respected their privacy and dignity. Arrangements were in place to promote patients’ privacy. National GP Patient Survey data showed people felt listened to and were treated with kindness. For example, 90% of respondents stated that during their last appointment, the healthcare professional was very good or fairly good at treating them with care and concern. This was comparable with the national average of 85%. Eighty-eight percent of respondents stated that during their last appointment, the healthcare professional was very good or fairly good at listening to them. This was comparable with the national average of 87%.

Clinical staff we spoke with understood Gillick competency and there was a process to ensure young adults had control over their own privacy and the amount of parental involvement in managing their care and support.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. Data from the National GP Patient Survey data showed that 94% 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 comparable with the national average of 91%.

The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. People’s communication needs were met to enable them to be fully involved in their care. The practice had identified 403 people registered with the service as carers which was 5% of the practice population. Systems were in place to support this group of people.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. Staff helped people and their carers to access advocacy and community-based services. Reception staff supported people to complete the online triage form if they were unable to complete this themselves.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs and acted to minimise any discomfort, concern or distress. Data from the GP patient survey showed that 95% of respondents stated that during their last appointment they had confidence and trust in the healthcare professional they saw or spoke to. This was comparable with the national average of 92%.

There was an appointment triage process in place that ensured people with immediate needs had access to services. Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams.

The service did not always promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care. Some staff expressed concerns about unmanageable workloads and the stress and exhaustion it had caused. Some staff told us that return to work interviews had not been offered to them, after a period of sick leave, to assess if any reasonable adjustments were required. Staff were required to follow up leaders to ensure the completion of return to work interviews highlighting a perceived lack of clear responsibility and ownership for these duties. The practice’s recruitment policy stated that when staff left the service, an exit interview or questionnaire would be provided. We received concerns that this had not been provided despite requests. The provider disputed thisand sent examples where offers of an exit interview had been offered. Some staff were critical of the lack of support offered to them. For example, some staffexpressed concerns about the lack of support offered to them when they expressed concerns about the lack of training, workload and safety of the total triage system. The provider sent additional evidence to the CQC, such as the total triage policy, staff briefings and training offered to staff but failed to acknowledge that newly qualified GPs required additional support to transition into their new roles. The introduction of the triage system over and above this caused additional stress. One GP had left the practice and 2 had handed in their resignation. One told us they had considered leaving medicine altogether after their experience of working at the practice, another told us they were told they kept doing things wrong and this had affected their confidence. Another member of staff told us they had gone off sick with work related stress, prior to leaving, due to the pressure they were under. Other examples included the introduction of rapid changes within the practice, such as room changes, without an explanation of why or an assessment of the impact on staff.

However, most staff told us they felt valued by leaders. Leaders had taken some steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas. Team building days were established within the practice. For example, a summer BBQ and Christmas meal paid for by the partners. Staff were given Easters eggs at Easter. Some staff reported being supported by leaders when their personal circumstances impacted on their work.