Dr C D Lenton & Partners Also known as Ashfield Surgery

On this page

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

We carried out an announced assessment of 4 quality statements (Kindness compassion and dignity, Responding to people’s immediate needs, Treating people as individuals and Workforce wellbeing and enablement) under the caring key question and found: Patients are treated with kindness, empathy and compassion. They understand that they matter and that their experience of how they are treated and supported matters. Their privacy and dignity is respected. Every effort is made to take their wishes into account and respect their choices, to achieve the best possible outcomes for them. This includes supporting people to live as independently as possible.

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.

Staff treated patients with kindness, empathy and compassion. Privacy and dignity was respected and effort was made to take patients’ wishes into account and respect their choices. The 2023 GP patient survey data showed that patient satisfaction with their overall experience of the practice remained in line with national averages. Although patient satisfaction with their overall experience had fallen in 2022 to 64% from 83% in 2021, this had improved in 2023 to 69%. This was slightly above the local average of 65%. From the NHS website 8 people had commented positively about their overall experience or in regard to how caring staff were at the practice. The practice collected patient feedback using different methods, including the friends and family test. Between June 2023 and March 2024, 8889 patients had responded to the survey. Of those responding, 74% had commented that their overall experience was very good and 17% good. The practice had however identified that patients sometimes felt staff were not helpful. The practice had taken appropriate action to review results from the survey, investigate and improve. The patient participation group (PPG) had carried out a survey in October 2023, results showed that mostly patients had commented that staff were kind and helpful. Patients we spoke with during this assessment were positive about staff who worked at the practice. From the complaints that CQC had received, 3 were related to reception staff not being compassionate. However, when we looked into the complaints, the complaints were about processes not being effective in supporting patients with their immediate needs. The provider reviewed and responded to patient survey information and continued to make improvements to offer a more caring service. The provider was aware that triaging and allocation of appointments needed to improve and that this was negatively affecting patient’s experience. At the time of the assessment, new processes were being developed.

Leaders told us they reviewed patient feedback from a variety of sources and made improvements. For example, they had provided more information on their website and within the practice on other services that are available to support overall wellbeing. Leaders were aware that access to appointments and telephone access and delays in accessing secondary care were leading to poorer patient satisfaction. Staff had access to interpreters to aid communication. Leaders had identified that some processes were not working as well as they could and had developed solutions that would improve patient satisfaction for example with triaging and urgent repeat prescriptions.

All staff we spoke with during the assessment showed a caring attitude towards patients and wanted to help patients to achieve a high quality of care. During our onsite visit to the practice, We observed a number of patients attending onsite clinic appointments. We observed that staff were kind and receptive towards patients attending the practice that day. We spoke with two patients who felt the care and treatment they received on the day supported them to cope with and understand their condition and the care and treatment they needed. Patients told us that staff helped them to understand their care and treatment. We saw that notice boards at the practice had been updated to provide patients and their carers with information on their care and access to community services. The practice website also provided patients with information on services available to them both at the practice and locally. Information was available in accessible formats, large print and different languages where needed.

The 2023 GP patient survey data showed that patient satisfaction with being treated with care and concern by the healthcare professional and being involved in decisions about their care and treatment remained high and above local averages.

Staf told us patient’s individual needs and preferences are understood and these are reflected in their care, treatment and support. Staff had access to interpreters or used alternative methods to communicate with patients to ensure needs were met to enable them to engage in their care, treatment and support to maximise their experience and outcomes. Patients were supported to manage their health in a way that made sense to them.

To support patients with their general health and wellbeing or with non-medical related issues, the practice had processes in place to refer patients to the social prescriber. However, we found the process was not fully embedded and not all staff knew about the service or how to refer patients. We found the practice had processes in place to monitor what outcomes had been achieved following intervention with the social prescriber. The practice had systems in place to be able to record patient preferences including if they needed an interpreter. The practice held a register of carers that were registered with the practice and was working with the primary care network (PCN) to employ a carer’s coordinator that would offer more support and advice to carers and patients. From records that we reviewed, we saw that patients were involved in decision about their care. Care plans were formed with patients and information was communicated in a way they could understand, that allowed patients to make informed decisions.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

The 2023 GP patient survey data showed that patient satisfaction with how well they felt listened to by the healthcare professional had improved from 85% to 89%. This was above the local average of 81% and national average of 85%. Feedback from a manager of a local care home, where residents were registered with this GP practice, was positive about the systems in place that allowed effective communication between the care home and the GP practice. This meant residents received timely assessment and treatment.

Not all staff we spoke with had received training on signposting to other services or on how to refer to the social prescriber. Non-clinical staff also told us they had not received training on how to triage or prioritise urgent appointment requests. We saw that information had been shared within the practice on which services to signpost to and leaders told us that written guidance had been produced on how to perform a basic triage or decide if an appointment was urgent and this information was available for all staff. The provider was developing more detailed information for staff on more effective triaging. Staff told us they used interpreters where needed to help support conversations with patients. Leaders told us a new role had been created, a complaints handler administrator, this was to support patients who wanted to raise a complaint verbally. However, at the time of the assessment, not all staff we spoke with were aware of this role. Leaders were aware of the difficulties patients faced in getting through to the practice or in accessing an appointment and were taking action to improve.

Staff feedback was mixed about support in place to deliver high quality services. Staff told us they felt supported to meet the requirements of professional revalidation and leaders supported staff when they were experiencing difficulties in their personal circumstances. Although staff felt they had someone to report concerns to, they did not always feel listened to or confident that action would be taken. Staff told us they did not have regular opportunities with their colleagues and the wider practice staff to discuss and share concerns or ideas for improvements to improve patient or staff experiences. Staff told us that workloads were not always manageable or that they were not given enough time for required training or other non-clinical tasks and this placed additional pressure on them. Leaders told us staff had access to an employee assistant program where staff could access personalised support including for counselling and legal services. Leaders told us although they had not recently carried out a staff survey, staff could give feedback, and this was raised in practice management meetings. We found risk assessments and arrangements were in place for managing the premises and safety of staff. Leaders told us how staff were supported during religious events. For example, clinics and appointment times were amended to support staff with their overall wellbeing. Leaders told us when they received positive feedback from patients about staff, for example through the friends and family test, they shared this good feedback with relevant staff to keep morale high. Leaders told us they were aware that staff morale was not always as good as it could be and they had started to implement measures to try to support staff and improve wellbeing. We found this was not consistent for all staff groups. For example, the GPs met for 20 minutes on a Monday morning to have a general discussion. However, there was no such opportunity for other clinical or non-clinical staff.