The Old Court House Surgery

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 with advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this. At our last inspection in October 2016, using our old methodology, we rated this key question as good. At this assessment, the rating remains the same.

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. Feedback from people using the service was positive. People felt involved in any assessment of their needs and felt confident that staff understood their individual and cultural needs. Reception staff used digital flags within the care record 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 heath, care and wellbeing during reviews. Care plans and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) records were completed and reviewed regularly. The provider had effective systems to identify people with previously undiagnosed conditions. 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. Systems were in place to ensure staff had received training in the latest guidance and legislation through regular staff training sessions. The clinical records that we reviewed demonstrated care was provided in line with current guidance. Data quality on the clinical system used by the practice was regularly checked.

The service worked well across teams and services to support people. The staff had access to the information needed to appropriately assess, plan and deliver people’s care, treatment and support. The practice worked with other services and healthcare partners to ensure continuity of care, including where clinical tasks were delegated to other services. All relevant teams and staff were given access to information and guidance as they were made available.

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. Practice staff referred patients for smoking cessation and weight loss to the Primary Care Network (PCN) social prescriber who was reported to be very responsive to the needs of the patients. The practice also engaged in campaigns to educate patients in the services that they offer in order to increase uptake of services such as cervical screening.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, but did not always meet clinical expectations in some areas. The service routinely invited patients for childhood immunisations; however, the uptake remained below the national average. The practice uptake for the cervical screening programme was also below the national average. The leaders explained that the population was very hard to reach due to it being a very mobile population with many having a very limited use of English. A number of patients have been registered who were originally from Ukraine and the practice were working hard to ensure a full medical history was recorded. This has had an impact on national data. The practice had robust recall systems in place to ensure patients receive cervical screening and immunisations. The practice provided unverified data that some improvement has been seen.

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. Capacity and consent were clearly recorded. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.