Archived: Tollgate Health Centre

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

People were treated with kindness and compassion; however, staff did not always protect their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and treatment, however patient satisfaction was not monitored to identify areas of improvement. The service did not always support staff wellbeing. At our last assessment, we rated this key question as good. At this assessment, the rating has changed to requires improvement.We identified breaches of regulation in relation to safe care and treatment, staffing and good governance.

This service scored 45 (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 did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

Arrangements were not always in place to promote patients’ privacy. We found staff were unable to describe where confidential patient conversations could take place away from the reception area. We did not see information to support patients wishing to speak in confidence. National GP Patient Survey data reflected people felt listened to and were treated with kindness. We observed staff speaking to patients clearly and with empathy. Staff we spoke with understood Gillick competency 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. We did not see evidence that staff analysed feedback to help monitor patient satisfaction. Chaperones were available if needed and privacy screens were used to help maintain dignity, however staff who chaperoned patients had not always received chaperone training.

The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Patients’ personal, cultural, social, religious and equality characteristics needs were not always understood and met. Patient communication needs were not always met to enable them to be fully involved in their care. Reception staff we spoke were not familiar with communication aids on the reception desk to support people with hearing loss.

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 patients and their carers to access advocacy and community-based services. The practice employed a social prescriber through the Primary Care Network (PCN).

The service did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Emergency medicines and equipment did not comply with national quality standards. Medicines in the practice to help manage medical emergencies were not located in a safe area. The practice had identified a resuscitation lead; however, they told us they did not have protected time to undertake their role. Risk assessments had not been undertaken to evidence the rationale for not stocking recommended equipment and medicine. There was a system for appointment triage that ensured people with immediate needs had access to services. Staff we spoke with were not always clear on the process for referral to emergency support, including mental health crisis teams. Annual sepsis awareness training for all staff was overdue.

The service did not always care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.

Staff told us they did not always feel valued by leaders. Leaders had not taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas. Staff reported they were struggling at work. Staff did not have annual appraisals and told us they were not allocated protected learning time to support lead roles within the practice. Ongoing professional development needs had not been identified by and supported by leaders. Staff told us they undertook their own self-directed learning. Staff immunisations information had not been collected for all staff where relevant and there were no risk assessments to demonstrate that risk had been assessed and relevant action taken to protect staff and patients.