The Randolph 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

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this. At our last inspection, we rated this key question as good, at this inspection the rating has remained the same. Our clinical searches found that the practice had internal process and systems which helped to improve monitoring of medicine reviews and long term conditions. The practice used an internally developed tool to monitor and manage patients as the tool provided comprehensive patient insight data that helped to support the management of patients'health by using metrics from the clinical system.

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 practice made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs.Feedback from people using the service was positive for this and people felt confident that staff understood their cultural needs. Leaders and staff told us the practice uses codes and alerts flags within the care records system to highlight any specific individual needs, such as the requirement for a translator. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. The practice had effective systems to identify people with previously undiagnosed conditions. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The practice had systems in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we saw demonstrated care was provided in line with current guidance. Our clinical record searches found the majority of patients were receiving safe management and monitoring for medicines within the advised time frame for instance, the monitoring of patients on high risk medicines. The leaders informed us they put in place internal protocols and systems processes to effectively manage this. The practice held registers for patients and provided annual health checks for those with learning disabilities, people with severe mental health conditions, palliative patients, and vulnerable patients.

The practice worked well 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. There were established pathways for staff to follow to ensure patients’ needs were met. The practice worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services and community professionals using the same system. The processes in place enabled staff to liaise regularly with community teams such as community nurses, health visitors, and palliative care nurses. Staff told us regular multi-disciplinary team meetings were held where vulnerable people, or those receiving end-of-life care were discussed and actions recorded.

The practice supported people to manage their health and wellbeing to maximise their independence, choice and control. The practice supported people to live healthier lives and where possible, reduce their future needs for care and support. We found processes were in place to support people to live healthier lives. Leaders told us about health education events that have happened at the practice and future educational events that the practice is planning.

Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity. Patients had access to a social prescriber, which helped them improve their health, well-being, and social welfare by connecting them to community services. Healthy living information was available on the notice board in the waiting room and on the practice website. We saw the practice website had links to health and wellbeing information. We found processes helped to support people to live healthier lives.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The practice didn’t meet national targets for their childhood immunisations and cervical cancer screening. For example 68.1% of children aged 5 had received 2 doses for Measles, mumps, and rubella (MMR) and the World Health Organisation (WHO) recommends a rate of 95%. Additionally the cervical cancer screening rate for 25 to 49 year olds was 52 %, but the national target rate is 80%. Leaders were aware of this and had put an action plan in place, patients were actively followed up via text messages, letters or phone calls to encourage patient uptake. Leaders told us they were planning more educational health events specifically focussing on women’s health and child immunisations. The impact of previous health education events is yet to be seen for the practice. Leaders informed us that some of their patients opted for private healthcare or declined in relation to immunisations and screening, althoughthe practice didn't provide any evidence to support this.

The practice told people about their rights around consent and respected these when delivering care and treatment. Staff who carried out chaperone duties were trained for the role and had received appropriate Disclosure and Barring Service (DBS) checks. Posters were displayed in the practice informing people this was available to them.

Staff understood and applied legislation relating to consent. Capacity and consent were clearly recorded. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation. There were no concerns raised by those using the service about consent to care and treatment.