Olive Medical Practice

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

This service scored 46 (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 usually made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. However, our clinical searches identified areas where the monitoring of patient’s conditions was not up to date, or it was not apparent their condition had been monitored elsewhere.

Reception staff used digital flags within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present.

The results of the National GP Patient Survey were slightly below national average. For example, 89% felt the healthcare professional they saw had all the information they needed about them, compared to 92% nationally and 92% locally, and 84% felt their needs were met during their last general practice appointment, compared to 90% nationally and 91% locally.

The practice did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Clinical records we saw did not always demonstrate care was provided in line with current guidance.

Meetings were held, but the practice manager told us minutes were not kept for clinical meetings. Minutes were kept for meetings between managers and the GP partners. These did not contain details to evidence that guidance was being disseminated.

The experience of people who used the service as indicated in the National GP Patient Survey showed that 87% of respondents (compared to 93% nationally) stated that during their last appointment they had confidence and trust in the healthcare professional they saw or spoke to.

Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support. When people moved between services, all necessary staff, teams and services were involved in assessing their needs to maintain continuity of care. Multi-disciplinary meetings were held so that when people received care from a range of different staff, teams or services, this was coordinated.

The service did not always support people to manage their health and wellbeing, so people could not maximise their independence, choice and control. The service did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

The practice supported national priorities and initiatives to improve the population’s health, including stop smoking and tackling obesity campaigns. Patients were encouraged to attend cancer screening and take up vaccinations offered as part of national programmes. However, the practice was below target for the percentage of persons eligible for cervical cancer screening who were screened adequately within 3.5 years for persons aged 25 to 49 (43%, expected rate 80%), and within 5.5 years for persons aged 50 to 64 (63%, expected rate 80%). They were also below target for childhood vaccinations.

The practice did not always have a proactive and positive culture of safety based on openness and honesty. They did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

The practice had a significant events policy. This gave examples of what should be recorded as significant events, including new cancer diagnoses, and events that had resulted in a complaint. None of these examples had been recorded as significant events. The policy did not state who was responsible for any aspect of significant event reporting. There was no system to monitor significant events to say how many there had been, at what stage any investigation was at or if any themes had been identified. The practice worked closely with a practice in a neighbouring area. Significant events for both practices were kept and dealt with together so there was no insight into what issues were specific to this practice.

We reviewed 4 significant events forms. These did not contain enough information to determine exactly what had happened, what action had been taken or was required, or if learning had been shared and embedded. For example, an incident about a needlestick injury did not make it clear who had been injured, or what the advice from Occupational Health had been, and an incident about a cold chain breach did not indicate what the result of the investigation was. One significant event had not identified a possible data breach as a result of an error. In addition, we were told about a serious incident in the practice a month prior to our assessment. Although this had been discussed in a meeting of the GP partners, no significant event form had been completed and there was no monitoring of actions that were required to stop the incident being repeated.

Significant events were discussed at the partners’ meetings, but minutes did not clearly indicate outcomes. Some staff, including clinicians, told us they were not invited to meetings where significant events were discussed. The practice manager told us they were informed about them if they were directly involved. We reviewed minutes of administrative and reception meetings from November 2024. No significant events had been discussed.

Patients usually felt they could make an informed decision about their care and treatment because they had been provided with the information, they needed to support them to do so. The National GP Patient Survey results indicated showed that 85% of respondents had stated that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment, compared to 91% nationally 92% locally. Staff understood the importance of ensuring that people fully understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. There was a system in place to record people’s consent appropriately. Clinical staff were trained in the Mental Capacity Act.

The provider could not provide any records of patients with a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision in place. Although the practice told us they had patients with a DNACPR decision, these were not coded in a way that could identify them, so they were unable to review them.