Grove Surgery

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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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first inspection for this practice since its registration with CQC. This key question has been rated as requires improvement. Requires Improvement: This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. The practice was in breach of the legal regulation relating to safe care and treatme

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice did not always make sure people’s care and treatment was effective. As part of the assessment a number of set clinical record searches were undertaken by a CQC GP specialist advisor. A sample of the records of patients with long-term health conditions were checked to ensure the required monitoring was taking place. These searches were visible to the practice. We found the search for patients with the possible diagnosis of diabetes following a blood test result, identified 6 patients. We sampled 5 and found the practice were not robustly following the interval testing for a raised HbA1c (average blood glucose) and annual medication reviews were overdue. We reviewed 4 out of 32 patients with asthma who had received the 2 or more courses of rescue steroids and found 3 had been reviewed but had no clinical assessment recorded in the clinical reco rd and no safety netting follow-up. Two required steroid cards but these had not been offered. The search identified 5 out of 313 patients diagnosed with hyperthyroidism who had not been monitored for 18 months. In addition, we reviewed 10 patient consultation records carried out by the practice nurse and found 8 records where guidance was not fully followed. The national GP patient survey carried out from January to March 2024 had 119 responses. This asked patients whether their needs were met, was the healthcare professional good at listening to them, and were they involved in decisions about their care. The patients’ responses for these categories were below the national and local area national averages.

The practice did not always plan and deliver people’s care and treatment following evidence-based care and treatment. Leaders and staff told us the practice had systems and processes to keep clinicians up to date with current evidence-based practice. Staff had access to the National Institute for Health and Care Excellence (NICE) guidelines, monthly clinical meetings. In addition, staff had protected time to attend training. However, as part of the assessment a number of set clinical record searches were undertaken by a CQC GP specialist adviser and a specialist practice nurse which demonstrated that best practice guidance and standards were not always fully followed.

Although staff told us they did not attend any regularly meetings with other health professionals to review patients with complex or safeguarding needs, they explained they would contact them if they required any support. When a patient was discharged from secondary care into primary care with complex needs the practice would review the patients’ needs and carry out a home visit if appropriate. The practice was informed about patients who had attended any emergency services promptly. The practice supported 3 residential care homes, we spoke with two who stated staff responded promptly to their needs and they had weekly contact with a GP.

The practice supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff said patients had access to social prescribers, health and well-being coaches, mental health specialist nurses, physical activities and a local weight loss programme. Posters and leaflets were available to direct patients where to seek further advice. The practice had a phlebotomist to enable patients to have their blood tests at the practice.

The practice had monitored some patients’ outcomes. The practice manager explained they had systems in place to monitor patients with long term health conditions and the partners had regular discussions about clinical performance, however, they did not keep a record of this. The practice submitted their performance data for 1 April 2023 to 31 March 2024. This found the practice had completed 100% of patients’ mental health and learning disability annual reviews, and chronic obstructive airways and dementia annual reviews, but had not achieved full patient uptake of asthma and diabetes annual long term condition reviews. The practice’s uptake for cervical screening and childhood immunisations were below the national targets. The practice submitted five audits carried out in February and March 2024, where the practice was monitoring patient outcomes. The practice had carried out their own patient feedback surveys and annually reviewed the GP patient survey and put actions in place to improve the service, for example improving the telephone system.

The practice told people about their rights around consent. Most clinicians understood the requirements of legislation and guidance when considering consent and decision making. We saw that consent was documented. Clinicians supported patients to make decisions. Where appropriate, they assessed and recorded a patient’s mental capacity to make a decision.