Green Meadows 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

Responsive – this means we looked for evidence that the provider met people’s needs. At our last inspection we rated this key question requires improvement. At this inspection the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

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. We reviewed available data about patients’ experiences when receiving care from the service. This included the national GPPS. Results showed patients had trust and confidence in the healthcare professionals at the service. Feedback received directly by the CQC also supported this. Staff and leaders understood the demographic and needs of the practice’s patient population and spoke of adjustments they made to support patients’ individual needs and preferences. For example, translation and interpretation of information, adjustments to appointments such as face to face and, waiting in a quiet area. The practice had systems and processes to identify, record and share information about patients’ needs and preferences within the practice and with external partners.

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 heard how the practice worked in partnership with a range of health care professionals and organisations to communicate and meet the needs of patients. Systems and processes existed to ensure patients were triaged to the correct healthcare professional and had timely access to appointments. This was delivered by a model called Total Triage where the duty doctor triaged all requests with a care coordinator working alongside them to book and signpost patients. This enabled continuity of care for patients because once triaged, they were offered the choice of an appointment with the most appropriate healthcare professional or their preferred named clinician.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Leaders and staff told us that patients had access to interpreter services, including British Sign Language. Systems and processes existed to ensure the information provided met the Accessible Information Standard. Polices reviewed as part of the inspection also showed patients could access information that they could understand and met their communication needs. Systems and processes existed to ensure patients communication needs were identified, recorded and shared within the practice. Staff and leaders all confirmed they understood these processes. We also heard how staff had supported patients to access information about their health when patients were less confident in using technology. Patients that submitted feedback to CQC during the inspection did not raise concerns about the provision of information by the practice.

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. The number of complaints had significantly reduced. We reviewed the complaints log and a sample of complaints and found they had been managed in line with the practice’s own policy. Staff and leaders told us systems existed to share learning from complaints with all staff. Systems and processes existed to ensure there were a variety of methods to provide feedback in accessible ways. Leaders spoke positively about taking a proactive and co-productive approach when responding to feedback. We spoke with a member of the PPG who explained they felt the group was valued by the practice and had a key role in shaping improvements to the service through feedback from patients. The practice continually surveyed and gathered feedback from patients. This data showed patients had positive experiences when accessing the service. Staff and leaders described how this data reflected the changes that had been introduced. Although the GPPS survey results remained below local and national averages they demonstrated year on year improvement.

The service made sure that people could access the care, support and treatment they needed when they needed it. Feedback received from patients including the feedback received by CQC highlighted there had been 2 main concerns which were the online and telephone routes of access. The practice was aware and had made changes in response to improve patients’ experiences when accessing the service. Leadership recognised outsourcing telephony had not achieved expected outcomes and brought this back inhouse under the practice’s control managed by internal staff. Feedback had indicated online access did not meet patients’ needs, in response the practice had extended the available times and ensured access was equitable for all patients. More recent feedback received by CQC indicated positive changes had been made.

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. 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 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. Systems existed to share information within the practice about patients’ individual needs and preferences.

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 reviewed a sample of patients’ records who had completed Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and were assured that their wishes were documented and ready to be shared with other services when necessary. A monthly meeting to discuss all patients in the community took place with standing items on the agenda including end of life care and patient’s wishes and preferences for future care. This forum enabled communication about patients’ needs with other partners.