Archived: Glemsford 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 practice met people’s needs, and that staff treated people equally and without discrimination.

At our last assessment, we rated this key question as Good. At this assessment, the rating Good remains the same.

This service scored 75 (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 had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People felt they could raise concerns and felt staff treated them with compassion and understanding.

Leaders at the practice encouraged staff to raise concerns when things went wrong. We saw in the minutes of staff meetings, concerns were discussed, and learning and action points were agreed. We found actions identified had been completed or an appropriate time period for the actions to be completed was seen. Staff felt there was an open culture, and that safety was a priority. The provider had processes for staff to report incidents, near misses and safety events. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that improved care for others. For example, following complaints from people who could not use the online appointment system, a process was initiated for receptionists to create a sign in and book an appointment.

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

Arrangements were in place to ensure people were seen by an appropriate clinician if needed. Clinicians could request to follow up people, based on their clinical needs to provide continuity of care.

Leaders at the practice had a good understanding of the needs of their local population and provided a range of services at the practice which included for example, a Health and Wellbeing Coach, a Social Prescriber and a Physiotherapist.

We received positive feedback from practice partners in relation to how practice staff worked with them to increase the availability and provision of practice services.

The practice supplied appropriate, accurate and up-to-date information in formats that were tailored to people’s individual needs. We did not receive any concerns from people regarding accessibility to appropriate, accurate and up-to-date information in a way that suited their needs.
We were told information was available to people in different formats, and we saw flags on peoples records alerting staff if they had any communication or accessibility needs.

Interpreter services were available for people whose first language was not English, and for people with a hearing impairment. Staff told us about the arrangements in place to book an interpreter.

Easy read and pictorial information was available at the practice. Information was available for people on the practice website about how to access their care records.

Information to promote the uptake of screening and immunisation programmes was available within the practice and on their website.

The practice made it easy for people to share feedback, ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and made changes with people’s agreement and consent.

People who provided feedback had no specific views or concerns in this area. Care home representatives told us they had been listened when they gave feedback, and changes had been made to arrangements for the care home with regards to accessing and communicating with the practice.

Complaints information was available in the practice and on the practice website. People were advised of the contact details of the local integrated care board (ICB) complaints and PALS service and the Parliamentary Health Service Ombudsman if they wanted to escalate their complaint.

We saw complaints were managed in line with the practice policy and learning from complaints was evident when we spoke with staff. For example, staff training was provided and an explanation with an apology was given to the people that had raised a complaint.

The practice also recorded, reviewed, and shared positive feedback from people with the staff. People registered at the practice were encouraged to provide feedback and make suggestions about the practice on their website.

In response to the National GP Patient Survey data and feedback from members of the community, the practice had identified changes to improve access to the practice. For example, following the introduction of their online booking system, the practice had received many complaints particularly from people who had limited or no access to the internet. People we spoke with during the onsite assessment told us that recent changes had improved their access, this was due to the receptionists supporting those who did not have internet access, a computer, or smart phone to register and book an appointment on the online booking system on their behalf. This new process need to be embedded and expanded for assurance there is equity in access to the practice.

The practice provided people with long term conditions appointments of 40 to 50 minutes to ensure a full review. People with a learning difficulty were also provided with 40 minute appointments as part of their annual health check.

The practice environment was accessible with all treatment rooms on the ground floor and an automatic door to the entrance of the building.

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

We received no specific feedback from people regarding their experiences for this quality statement. The care home representative told us people received weekly visits with continuity of staff which had improved outcomes for people.

We saw that staff treated people equally and without discrimination. The practice used appropriate systems to capture and review feedback from people, including those who did not speak English or have access to the internet.

Arrangements were in place for the care coordinators to engage with people who were more likely to experience inequalities in health and outcomes.

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.

We received positive feedback from people, which included the care home representative about how the practice staff supported people to plan for their future and in meeting people’s end of life care needs.

The practice held a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) policy. We reviewed the records of 2 people who had a DNACPR and found alerts were in place on both records, this information was easily available to other health care professionals. Care home representatives confirmed their residents all had DNACPR/ReSPECT documentation that was reviewed regularly with the respective residents or their carer’s.

The practice maintained a list of people with palliative care needs and people at the end of their life. They had systems in place to support and review people, which included people who lived in a care home, those who were housebound, and worked in partnership with other organisations. For example, there was a weekly ward round at the care home.