Dockham Surgery

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.

This is the first inspection for this service since its registration with CQC. This key question has been rated as Requires improvement

The service was in breach of legal regulation in relation 16, complaints were not investigated and responded to in line with the service’s policy and improvements were needed to ensure learning was actioned and monitored.

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 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 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.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

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.

We saw the practice worked in partnership with other services to meet the needs of its patient population. There were established mechanisms for engaging with the community healthcare provider.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information to promote the take up of screening and immunisation programmes was available in a range of languages. The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard. Patients were informed as to how to access their care records.

The service did not always follow its own complaints policy to ensure that all concerns were investigated and responded to fully. People were involved in decisions about their care and treatment and were informed of changes to this.

People were supported to raise concerns and felt staff treated them with compassion and understanding. There was a system to record and investigate complaints. However, improvements were needed to ensure it was effective and addressed concerns raised fully.

We reviewed complaints received and acted on by the practice. The complaints policy set out the process to be followed and timescales for responding. We found responses to complainants did not fully address the concerns they had raised, and we were unable to fully track how learning had been implemented and monitored.

In addition, investigations into complaints about clinical concerns were not carried out by a clinician as stated in practice policy. There was no record of verbal concerns or complaints received which had taken longer than 24 hours to resolve, as recommended in national guidance.

The complaint policy also referenced a Primary Care Trust in another geographical area. (Primary Care Trusts were the organisations responsible for commissioning services before Clinical Commissioning Groups were formed.) There was also a reference to gaining consent of ‘the immediate relative’ if the concern was regarding a deceased patient, but no definition of who would be an immediate relative.

The service made sure that people could access the care, support and treatment they needed when they needed it.

Information from the National GP Patient Survey data showed 51% of respondents responded positively to their overall experience of contacting the GP practice, compared with the national average of 69.9%. A total of 32.4% of respondents to the National GP Patient Survey found it easy to contact the practice by telephone, compared to the national average of 52.9%. The service had acted on these results and changed the provider of the telephone service, so that people had a call back option. The number of reception and clinical staff had also been increased to improve access. The service continued to monitor call data and using this for planning future appointment availability and staffing needs.

For example, they had extended appointments for people with a learning disability. People could access the service to suit their needs for example online, in person and by telephone. Treatment rooms were available on the ground floor.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Feedback provided by people using the service, both to the provider as well as to CQC, was positive. Staff treated people equally and without discrimination. 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. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. 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 could have enough time to make informed decisions about their future, including at the end of their life.

Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. This information was shared with other services when necessary.