Cranford Medical Centre

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• 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 assessed all the quality statements from this key question. Our rating for this key question has improved from requires improvement to good. We found 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.

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.

Feedback from people using the service was positive. People felt involved in any assessment of their needs and felt confident that staff understood their individual and cultural needs.

Reception staff were aware of the needs of the local community. Reception staff entered 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. Staff checked people’s health, care, and wellbeing needs during health reviews.

Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. The provider had effective systems to identify people with previously undiagnosed conditions. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

People we spoke to had no concerns relating to evidence-based care and treatment.

Clinical staff told us they kept abreast of current evidence-based guidance and gave examples of how they were updated. Staff who were responsible for reviews of people with long-term conditions told us they had undertaken specific training.

Our remote clinical searches showed that the practice had effective processes to ensure care and treatment was delivered in line with evidence-based practice and legislation. We identified an area for improvement relating to acute asthma reviews. Following the assessment, the practice created a protocol for ensuring these people were managed in line with current guidelines.

People we spoke to had no concerns relating to how staff, teams and services work together.

Staff told us they worked effectively as a team and enjoyed coming to work. They were aware of the value of working across services and sharing knowledge and experiences to get the best outcomes for people. Leaders welcomed partnership working and worked with the PCN to provide out of hospital services including warfarin monitoring, diabetes clinics and extended access.

Feedback from partners showed that the practice worked with others to improve people’s health and safeguard people from abuse.

Regular meetings were held between the service and other health and social care services to ensure continuity of care. Care was delivered and reviewed in a coordinated way when different teams, services or organisations were involved. Social prescribers referred people to services in their local community.

People we spoke to had no concerns relating to supporting them to live healthier lives.

Staff told us they supported people to manage and monitor their own health. Staff told us they discussed changes to care or treatment with people and their carers. Leaders told us the practice was involved in a project to tackle health inequalities.

The practice had call and recall systems in place for learning disability checks, cervical cancer screening, child immunisations and long-term condition reviews. New patient health checks were also undertaken. In the last 12 months the practice had completed 22 learning disability reviews out of 26 eligible people.

People told us they were satisfied with the monitoring of their conditions.

Staff told us they carried out reviews of people’s health conditions at regular intervals to ensure positive outcomes.

Our remote clinical searches showed that the practice had effective systems to monitor and improve outcomes for people. The practice had undertaken medicine audits to monitor and improve people’s outcomes. We saw that audits had been undertaken for anticoagulant medicines, high-risk medicines and medicine safety alerts. A medicines reconciliation and post discharge review audit had been undertaken. The practice told us about other quality improvement work undertaken to improve people’s outcomes including additional training for lipid management care and the management of chronic kidney disease (CKD) and chronic obstructive pulmonary disorder (COPD). The practice had undertaken audits to improve cervical cancer screening and child immunisation uptake.

The practice was taking action to improve uptake of cervical cancer screening and child immunisations. Actions included sending text messages with an appointment booking link, a care co-ordinator calling hard-to-reach people and a health and wellbeing coach visiting people in health inequality postcodes and booking an appointment for people to increase uptake.

People we spoke to had no concerns relating to consent to care and treatment.

Staff we spoke to could explain how they spoke to people and gained consent. Clinical staff understood the requirements of legislation and guidance when considering consent and decision making.

Policies, protocols, and guidance were in place to support people to consent to care and treatment. Clinicians supported people to make decisions. Where appropriate, they assessed and recorded a person’s mental capacity to make a decision within the patient record. Staff had undertaken Mental Capacity Act 2005 training.