Harris Memorial 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

Staff treated people equally and without discrimination. There was a process to clinically review and triage patients and refer them to the appropriate service to meet their clinical needs. The practice had a system which alerted staff to any specific safety or clinical needs of a person using the service. The practice took complaints and other patient feedback seriously and leant form them to improve the quality of care. People were involved in planning their care and understood options around choosing to withdraw or not receive care. At our last assessment, we rated this key question as Requires Improvement. At this assessment, we rated this key questions as Good.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff treated people as individuals and with respect. They offered care and treatment with a person-centred approach and re-direction to other services that best met the person’s needs.

Staff and leaders worked together in a multi-disciplinary approach to ensure people received the appropriate support at the right time. Some staff told us they had completed specialist training and had additional responsibilities linked to their role. For example, the clinical pharmacist had training and experience in diabetes management and was working on a quality improvement project regarding the monitoring and treatment of microalbuminuria (a small amount of protein found in urine which can sometimes indicate the incorrect functioning of the kidney and can sometimes be a sign of kidney disease), in people with type 2 diabetes. The importance of flexibility, informed choice and continuity of care was reflected in the services provided. The practice had a system which alerted staff to any specific safety or clinical needs. The practice made reasonable adjustments when patients found it hard to access the service.

Staff told us they provided people with advice and information in a way that helped them to understand their health needs. Where people’s needs could not be met by the service, staff referred them to the appropriate service. There was a system for staff to access interpretation services to support people who did not have English as a first language. The service website contained information about accessibility. For example, how to request large print or easy read documents or if there was a requirement for a British Sign Language interpreter.

Staff demonstrated their understanding of the importance of listening to people during their appointment. They helped patients to be involved in decisions about care and treatment. We reviewed a sample of complaints received by the service and evidenced they had been responded to and acted upon in a timely way in line with the providers complaint’s procedure. Complaints were reviewed regularly, and learning was shared amongst staff to drive continuous improvement. Information about how to complain was readily available via the service website. Complaints were listened to and responded to appropriately and acted upon to improve the quality of care.

The practice undertook patient surveys to review the quality of care provided. Although the practice did not question patients directly about equity in access, most patients were satisfied with the overall service. However, feedback from people indicated access was challenging and people were not always able to get an appointment for their care and treatment needs. Since the last assessment the practice had reviewed and developed their systems and processes for prioritising people presenting with the highest need. Staff had access to guidance to support decision making. Staff and leaders explained how they understood the needs of the local population and had developed the service in response. Staff told us they provided opportunities and support for different groups of the patient population to overcome health inequalities.

Feedback provided by people using the service, both to the provider and to CQC, was varied. Some people’s experience was positive, however, some people told us they did not feel they got the right support at the right time to meet their needs. Staff treated people equally and without discrimination. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. Staff had completed training in equality, diversity, and inclusion. The practice had processes to ensure people could register at the service, 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.

Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were made in line with relevant legislation. We reviewed 3 patient records,1 of these records indicated within a person’s hospital discharge letter details of a DNACPR, however, this had not been reviewed by the practice and was therefore not immediately apparent on the persons clinical records for clinicians to access. End of life care was delivered in a coordinated way which considered the needs of those whose circumstances may make them vulnerable. People’s wishes were recorded on their patient record which were available to local health providers who may need to access them.