Nettleham Medical Practice Also known as Dr Waller and partners

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The provider had received feedback that identified improvements were needed in patients accessing to access via the virtual receptionist function. We saw it was working with patients to educate and increase knowledge to enable better outcomes. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

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.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff recognised the local population needs and fully understood their service’s demographic and language requirements. For example, translators were utilised to assist with telephone consultations and in person appointments, where required.

Our review of clinical records showed people were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

National GP Patient Survey data reflected people felt involved in decisions about their care and treatment. The survey results showed 87% 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.

The patient participation group (PPG) said the practice involved them in decisions and were responsive to their suggestions.

Staff we spoke with demonstrated an understanding of the health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff worked with partners and organisations to meet the needs of its patient population, these included, age concern, health visiting, district nursing and palliative care teams.

Staff and patients told us the voluntary driver scheme was valued and well used.

The National GP Survey results showed 97% of patients felt the person seeing them had enough information about them which made the appointment time efficient.

The provider supplied appropriate, accurate and up to date information in formats that were tailored to individual needs. People were given clear explanations about their care, treatment options and any follow-up required. Staff ensured that information was easy to understand and provided additional written material where needed.

Information was available in different formats to support accessibility, including large print and translated materials when required to support people who faced communication barriers. Information provided by the service met the Accessible Information Standard, and people were informed about how to access their care records.

These arrangements helped ensure that people had the information they needed to make informed decisions about their health and wellbeing.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. The provider had received 16 complaints in the 12 months prior to this inspection, of which 3 were upheld, 6 partially upheld and 7 not upheld. . There were clear processes in place for managing them, and people were signposted to information on how to make a complaint through the website, written materials and direct communication with staff.

Staff told us they understood the complaints procedure and were prepared to respond promptly and fairly if concerns were raised. The service encouraged people to share their views, and feedback was used to inform decision-making and improvements. People were involved in decisions about their care, and the service explained what had changed when feedback led to service development.

The service made sure that people could access the care, support and treatment they needed when they needed it. Appointments were available in a range of formats, including online, in person and by telephone.

The provider had received feedback that identified improvements were needed in patients accessing the practice via the virtual receptionist function. We saw it was working with patients to educate and increase knowledge to enable better outcomes.

Longer appointments were available for people who required additional time, such as those with learning disabilities or more complex needs. Staff encouraged people to contact the service if they experienced difficulties arranging an appointment, and adjustments were made where possible.

All treatment rooms were located on the ground floor. The entrance at Nettleham Surgery had level access, and reception staff opened the door for people with mobility needs to ensure they could enter the building safely and comfortably. There was a step up to gain access to the Cherry Willingham surgery, the provider had applied for funding to ensure it met disabled access requirements going forward.

Feedback provided by people using the service, both to the provider as well as to CQC, was mainly positive. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities.

Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes for example, adopting the reasonable adjustment digital flag which indicates that reasonable adjustments are required for an individual patients and includes details of their significant impairments, the key adjustments that should be considered and any underlying conditions.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and military veterans. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet.

People were supported to plan for important life changes, so they had enough time to make informed decisions about their future. Clinicians discussed future care needs when appropriate and helped people understand their options, ensuring they felt prepared and informed.

Our review of records showed that people were supported to consider their preferences for their ongoing care, and this information was shared with other services when needed and with the person’s consent to support continuity and informed decision making, this included their wishes for end-of-life care.