Marazion 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 in March 2015, we rated this key question as Good. At this assessment, the rating remains unchanged.

This service scored 80 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

There were arrangements to promote patients’ privacy.

Staff understood Gillick competency (Gillick competency refers to the legal ability of a child under 16 to consent to medical treatment without parental consent, provided they have sufficient understanding and intelligence to appreciate the treatment's nature, risks, and alternatives) 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.

People described staff as compassionate, kind, and professional. Feedback from people included “I want to emphasise my high satisfaction with the standard of care; all the staff are professional, friendly, and attentive.” and “Everyone there, GP's, dispensary staff, patientadvisors, nurses, etc, are unfailingly friendly, proactive and, most importantly, very efficient. I feel in safe hands indeed and cannot praise the surgery enough.”

Results from the National GPPS showed that 97.9% of people who responded indicated that during their last appointment, the healthcare professional was very good or fairly good at treating them with care and concern, compared with a national average of 85.6%.

All relevant staff were trained in chaperone duties and there were notices throughout the service offering this service.

GPs had a designated patient lists to ensure continuity of care. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s personal, cultural, social, religious and equality characteristics needs were understood and met. People’s communication needs were met to enable them to be fully involved in their care.

The service was accredited as an Armed Forces veteran-friendly GP service and demonstrated a commitment to supporting vulnerable groups. Clinical notes were coded to ensure easy identification. The service had identified 352 people as carers (4.6% of service population) and 147 people as veterans (2% of the service population). The service supported carers and veteransinvolving with government services, charities and integrated health programs; offering financial aid, mental health support, practical advice, access to peer networks, and help with employment/housing.

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.

We saw that the service provides clear, accessible information on care and treatment options, supporting shared decision-making in consultations, including providing written information and signposting to other services and support of self-management tools.

Meeting minutes reviewed showed that clinicians routinely discussed and documented people’s consent, capacity, and involvement in decisions.

Results from the National GP patient survey showed that 98.1% of people who responded indicated that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment, compared with a national average of 92.1%.

People could access information in the service such as posters and leaflets, and on the service website to support them to make healthier choices. Staff helped patients and their carers to access advocacy and community-based services.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern, or distress.

There was a system for appointment triage 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.

We reviewed the appointment system and saw urgent medical needs were identified and these were prioritised appropriately. Staff highlighted the support of the daily Duty Doctor who validated decisions and was always available to respond to people’s immediate needs. During our site visit, we evidenced that on-the-day appointments were available for people with urgent needs. Staff were familiar with the process for referring patients to emergency support and were able to provide relevant examples of how this had been implemented.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff told us they were valued by management and leaders. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as encouraging regular breaks, providing rest areas and an employment programme which promoted staff wellbeing.

The service had policies that protected staff from bullying and harassment. Surveys were undertaken to collect staffs’ views and staff told us that they worked as part of a supportive team in a positive working environment.

Staff could raise concerns and had opportunity to discuss their wellbeing through individual appraisals. Staff told us they protected time to undertake their training and continued professional development.

Staff we spoke with reported that they were happy working at the service and felt supported and valued by leaders. They described the leadership team as approachable and responsive, and said they could seek advice and guidance at any time.