Green Porch Medical Centre

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed all 5 of the quality statements from this key question. We have combined the score for these areas with scores based on the rating from the last inspection, which was Requires Improvement. Our rating for this key question has changed to Good. We saw that people were treated with kindness, compassion and dignity. Staff treated people as individuals and promoted their independence, choice and control. The practice was responding to people’s immediate needs. There were systems and processes to ensure workforce well-being and enablement.

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 via the NHS website and the practices own survey was positive. It showed people felt they were treated with kindness, compassion and dignity in their care and support and they felt that staff listened to them and communicated with them appropriately and in a way they can understand. National GP Survey results in 2022, showed that the percentage of respondents who stated that the last time they had a general practice appointment, the healthcare professional was good or very good at listening to them was 71.9%. In 2023, these results showed a decline to 52%. The provider had made improvements based on feedback from people who use the service, which results in an increase in 2024 to 71.2%.

Staff knew and understood the people who used their services, including their preferences, wishes, personal histories and backgrounds. Staff and leaders told us they would respond to peoples needs quickly and efficiently. There were policies and procedures for staff to follow to ensure information about people was treated confidentially, as well as to respect their privacy. There was a culture of respect with colleagues from other organisations.

People’s privacy and dignity was respected and upheld at all times. There was a culture of kindness and respect between colleagues.

The World Health Organisation (WHO) recommends a rate of 95% for all routine childhood vaccinations. At our last inspection of the service, data showed these targets were not being attained in 2022. The provider sent us evidence to show improvements had been made in these rates. However, the practice faced barriers with parents not wishing to immunise their children, which had an impact in terms of increasing uptake. Cervical screening uptakes rates were below the national target rate of 80% in June 2023. The provider sent us evidence to show improvements had been made and the target rate had been attained at 86%.

Staff and leaders told us that people’s individual needs and preferences were understood and reflected in their care, treatment and support. They told us that people’s personal, cultural, social and religious needs were understood, met and clearly documented. Staff told us and provided evidence to show they had dedicated cervical screening clinics during different times of the day to suit those working, or those with children, and by using the self-book service on a software platform; which had helped to improve uptake rates for cervical screening.

The practice had systems and processes to ensure people’s communication needs were met, to enable them to engage in their care and treatment, and for them to be supported to maximise their experience and outcomes. There were systems and policies/procedures for staff to follow in relation to childhood immunisations. The practice were routinely monitoring people who had been contacted to attend for these, clearly recording when they had been declined and coding records so that further contact would not be made. There was also a process for documenting when immunisations had been administered elsewhere. In addition to this, the Kent and Medway immunisation screening team produced a report which showed low uptake rates for child immunisations across Swale and Medway, particularly for pre-boosters. To support uptake rates for Mumps Measles and Rubella (MMR) vaccines, the practice were utilising the the Kent and Medway Integrated Care Board Vaccination programme, where people who have not had MMRs (and were aged between 5-20) were contacted by a vaccination hotline and offered the vaccination.

We asked the provider to share details of our Give Feedback on Care process on their website and although we received 15 pieces of feedback, none were specific to this area.

Staff and leaders told us demonstrated that people were supported to have choice and control over their own care and to make decisions about their care, treatment and well-being. The practice supported people to understand their rights by using different ways to communicate.

There were systems, processes and policies and procedures to ensure peoples records were kept up to date with information that supported them to maintain relationships, as well as networks that were important to them.

Feedback from people via the NHS website and provided to CQC, was negative in relation to responding to peoples immediate needs. We reviewed these peoples records during our site visit and found the provider had taken appropriate action to ensure staff received further training, policies and procedures had been updated and people were reviewed in further consultations to ensure their needs had been met.

Staff and leaders told us that people’s needs, views, wishes and comfort were a priority and staff quickly anticipated these to avoid any preventable discomfort, concern or distress. Staff training ensured they were able to quickly recognise when people need urgent help or support and use appropriate tools and technology to assist. Staff were alert to people’s needs and took time to observe, communicate and engage people in discussions about their immediate needs.

People received safe, effective and person-centred care as the provider recognised and met the well-being needs of staff. These included the necessary resources and facilities for safe working, such as regular breaks and rest areas. Staff told us they feel valued by their leaders and their colleagues. They have a sense of belonging and the ability to contribute to decision making.

There were systems and process for staff and people to have regular opportunities to provide feedback, raise concerns and suggest ways to improve the service or staff experiences. If necessary, leaders provided a timely and considered response. The provider had completed a workforce well-being audit, which showed a positive culture of support and the promotion of staff well-being.