Castle Place Practice

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 Good.

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 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 had an effective triage system. This enabled people to access urgent, on the day or appointments booked in advance,complex cases to be reviewed, home visits and follow up home visits to be scheduled (dependent on people's clinical need).

The practice worked with mental health liaison teams, learning disability nurses and external agencies to co-produce care plans (where relevant).

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 people who used the service.

The practice had tailored its services to meet the diverse needs of its community. For example, building relationships with community groups to promote the take up of childhood immunisation and cervical screening programmes. There were established mechanisms for engaging with community healthcare providers, as the practice formed part of the community services provided by RDUH.

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 made reasonable adjustments to meet individual needs in line with the Accessible Information Standard.

Adjustments included: easy-read materials, interpreter services including Language Line and BSL Interpreter services, double appointments (as appropriate), carer involvement, translated materials, as well as flexible communication methods.

The PPG held member workshops in small groups to monitor what mattered to people and to design information that supported people to access it. For example, the repeat prescription process/platforms available and reviewing feedback from family and friends test results to identify themes and any issues.

People were informed as to how to access their care records.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Learning from complaints was evident and staff were able to identify changes made because of feedback from people who use the service. Complaints were managed through the Patient Advocacy and Liaison Service (PALs) and the Patient Experience Team. The practice monitored complaints and identified themes and trends. Records viewed showed complaints received were well managed and detailed the actions taken, outcomes, learning and Duty of candour in response to complaints.

The practice had identified feedback was negative regarding clinicians running late and people having to wait without being informed. As a result, the services’ IT Communications Lead added a delayed screen to the information screens in the waiting room. This meant that when a person was checked in at Reception or via the check in screen, they were allocated a number; the screen showed the person’s number in the waiting room and how many people were waiting for the clinician.

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

National GP Patient Survey data showed higher than average positive results for accessing the practice. Feedback from members of the community about the provider was also positive. People could access the service to suit their needs. For example, online, in person and by telephone. All treatment rooms were available on the ground floor.

To ensure people with learning disabilities and severe mental illness (SMI) had regular annual health checks and reviews; the practice team made personal phone calls to book appointments. This allowed the person maximum flexibility when planning their appointment, as well as the practice team being able to follow up those who do not attend. Appointments for these people were longer, adjusted, and enabled them to be supported by carers (where appropriate).

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 mainly positive. Feedback provided to CQC, in relation to access, was mixed. People told us they either had a good experience or they had difficulty accessing appointments. Staff treated people equally and without discrimination.

Leaders and practice staff proactively sought ways to address any barriers to improving people’s experience and worked with local organisations 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. Staff assisted people in registering for digital access, including offering digital inclusion support and tailored guidance for those less confident with technology and the practice was developing a process towards Digital Reasonable Adjustments.

The service could accommodate people with sensory needs to wait in the quieter areas rather than the waiting room (if appropriate and safe). The practice considered and always tried to accommodate requests for preferred times of day (if possible) to assist those who preferred the quieter times.

The service supported and promoted Health Passports for people who may need reasonable adjustments. We saw that flags were added to people’s records to ensure consistent and respectful care for people with specific needs. For example, learning disabilities, autism, mental health conditions, hearing impaired and visual impairment.

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 practice worked with mental health liaison teams, learning disability nurses and external agencies to co-produce care plans (where relevant).