The Cedars 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

People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those important to people, and took decisions in people’s best interests where the person did not have capacity.

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.

Staff told us how patients were asked when they registered with the practice and/or during consultations their preferred method of communication and if they require support. They considered people’s wider health, care and well-being needs and worked with partners to support them to access appropriate services.

There were systems and processes in place to assess, prioritise and review people’s care. Non clinician staff had been trained, received guidance and had access to supervision to assist them to triage patients effectively.

Patient records were appropriately coded and flagged to alert staff to individuals’ needs and preferences. Vulnerable groups were proactively invited for health checks, such as carers and those with long term health conditions.

Clinical staff received informal access to senior and specialist clinicians and regular formal supervision to ensure their decisions were reflective of national legislation, evidence-based good practice and required standards.

There were established and effective systems in place to identify, share and embed best practice. Audits had been conducted on administrative processes such as the timeliness of cancer referrals or safe prescribing. Regular management meetings were held. Risks were documented for discussion for example, poor clinical practice, changes to ways of working and delays in processing clinical referrals. Updates were given, or resolutions stated at subsequent meetings and via their shared record system accessible to all staff.

Staff worked effectively across teams and services to support people. Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support. We found clinical records were detailed and contained supporting rationales for actions taken. There were established and effective systems in place to ensure the timely and appropriate management of referrals. Meetings were held with partner services to support people to access and/or move between services.

Information was shared between teams and services to ensure continuity of care, for example when clinical tasks were delegated or when people were referred between services. People received care from a range of different staff, teams or services, it was co-ordinated effectively. All relevant staff, teams and services were involved in assessing, planning and delivering people's care and treatment and staff work collaboratively to understand and meet people's needs.

Staff supported people to manage their health and wellbeing so they can maximise their independence, choice and control. Staff signposted people and provided advice and guidance to support people to live healthier lives and where possible, reduce their future needs for care and support.

People were invited and supported to be involved in regularly reviewing their health and wellbeing needs where appropriate and necessary. People were involved in regularly monitoring their health, including health assessments and checks where appropriate and necessary with health and care professionals.

Staff told us they routinely monitored people’s care, booking follow up consultations and requesting additional interventions such as blood tests to continuously improve people’s health outcomes.

There were established and effective systems in place to identify and monitor people’s outcomes. This was achieved through formal quality outcome frameworks used by local commissioners of healthcare to inform conversations regarding performance. Whilst others were audits chosen and conducted by the practice in response to health priorities or safe concerns to understand and improve clinical performance.

We found pathology results were reviewed and actioned in a timely manner and people were supported to understand and manage their individual needs.

Staff understood and assessed children under 16 years were Gillick competent. Thereby able to consent to their own medical treatment, without the need for parental permission or knowledge.

Staff told us they received training in understanding and supporting people to make informed decisions. Consent was sought on separate occasions in accordance with best practice prior to some treatments to ensure patients had time to understand, consider and ask questions about the procedure.

The practice had established policies and procedures in place to ensure staff knew and observed best practice when recording and delivering care. Consent was appropriately obtained or documented prior to administer vaccinations to vulnerable people. Staff ensured best interest decisions were appropriately made and recorded for people who lacked capacity to make decisions. We checked clinical records and saw staff had appropriately recorded patients consent in their records.