Four Acre Health Centre

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 question as requires improvement. At this assessment, the rating has changed to good.

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 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. Feedback from Friends and Family Test data was positive about care and treatment. People who used the service felt they were well supported to understand their condition and were involved in decisions about their care and treatment and in planning for their future needs. GP Patient Survey data reported 93% of people who responded felt they were involved as much as they wanted to be in decisions about their care and treatment. This exceeded the local and national averages of 92% and 91%, respectively. Staff demonstrated a person-centred approach to their work. The culture and ethos of the service was to ensure a high level of patient satisfaction, and this was clear across all areas of our assessment. People who used the service shared examples of how staff had taken the time to make sure their needs were met, and people were highly complementary about staff in all roles.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Information about patient care, and treatment needs were available and shared between services. The practice was involved in the local community and advocated for the health needs of its patients. Partner organisations who provided feedback directly to CQC told us about the productive interactions and positive relationships they had with the practice. Services were tailored to meet the diverse needs of the population. The practice focused on promoting health education and preventative care initiatives. Staff were able to demonstrate how they encouraged patients to attend for screening programmes and child immunisation uptake. This included offering appointments 5 days a week outside of normal work and school times and providing home visits. The provider worked closely with the Primary Care Network (PCN) and helped to plan, develop and deliver services across the locality with a view to improving patient satisfaction.

Clinical staff were longstanding, and this provided a high level of consistency for people who used the service. When locum staff were used, they were known to the practice.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff told us they had increased promotion of the NHS digital application and supported patients to understand the benefits of accessing their medical records online. Patients who had difficulty using digital services were provided with accessible information and support. Patients with a learning disability could expect information to be available in different formats including pictorial, easy read and large print.The website was user-friendly and included a wide range of information, such as how to access local charities, support services, and other local providers like dentists and pharmacies. The practice was veteran and family friendly.Interpreter and translation services for people who did not speak English or who used British Sign Language were available.

The service made it easy for people to share feedback, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result. Complaint leaflets were available in reception and on the practice website. Clinicians gave out feedback questionnaires to patients to take away with them. We reviewed a sample of complaints and found they had been investigated appropriately. However, outcome letters were not sent to complainants following investigations and patients who remained unsatisfied were not routinely signposted to The Parliamentary Health Services Ombudsman. We discussed this onsite during our assessment. The practice was receptive to our feedback and provided assurance the process would be reviewed. Complaints were discussed at meetings and learning was shared to improve services. Reception staff told us how they dealt with people’s concerns daily and reacted to concerns before they escalated.

The service made sure people could access the care, support and treatment they needed when they needed it. GPPS data reported that 62% of people who responded felt their overall experience of contacting their GP practice was positive, which was below the local and national averages of 78% and 75%, respectively. The practice was able to demonstrate the efforts they were making to improve patient experience including the introduction of trained care co-ordinators to signpost people more effectively. The practice had introduced a call back system to reduce the amount of time people waited on the phone. Staff told us they were trained to ask about communication needs, provide information in a way that patients could understand, and arrange appropriate support when required. This included longer appointments, quieter waiting spaces, or assistance completing forms. People could access appointments in various ways including online, using the telephone and walk-in access at reception with visual and hearing support options available. The provider regularly reviewed accessibility feedback to ensure no group was disadvantaged by the mode of access.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience and outcomes and tailored their care, support and treatment in response to this. Leaders sought ways to address barriers to improving people’s experience. Staff identified patients at risk of inequality and tailored care to meet their needs. Staff were trained in learning disability and autism awareness. The provider enabled registration for all patients, including those in vulnerable circumstances, and staff adapted care to support inclusive, equitable outcomes. Patients had equal opportunities to access appointments provided by a range of multi-skilled clinicians.

Learning from complaints and concerns was seen as an opportunity for improvement, and staff could give examples of how they incorporated learning into daily practice.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. This information was shared with other services, as necessary. Multi-disciplinary meetings were held on a regular basis to discuss the needs of people receiving end of life care. Key staff had specific skills to understand and meet the needs of people and their families in relation to emotional support and the practical assistance they needed, including at the end of the person’s life.