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CQC outstanding practice: Is your practice caring?

Key learning points for GP practices from the CQC's examples of outstanding practice.

Supporting carers

Case study 1: Foxhayes Practice in Exeter, Devon is proactive in its support for carers. The computer system alerts GPs if a patient was also a carer. The practice also provides written information for carers to ensure they understand the various avenues of support available to them. The practice has links with a carer support worker and runs a carers group, which provides access to advice and information.

Case study 2: The Hall Practice in Buckinghamshire had a register of carers and a member of staff carried out the role of 'carers coordinator'. This staff member made annual contact with every carer on the register to personally ensure they were receiving the care and support they required. The carers register was then updated based on this contact.

Case study 3: Concord Medical Centre in Bristol developed a carers group and worked with the Carers' Association to ensure patients received the most up to date support and guidance. The practice arranged a weekly session with the Carers Association to see carers who may not be registered patients themselves. The Carers Association worked with the practice to deliver a carers awareness evening to provide additional support to patients.

Learning points:

  • How to you identify and support carers?
  • Do you have a carers register and how do you keep this up to date?
  • Are carers offered flu jabs and health checks?
  • Do you have a process for supporting carers who are not on your patient list?
  • Do all staff in the practice understand the important role

There is more advice on making your practice carer-friendly here.

Innovative services and going the extra mile

Case study 1: The CQC said that Foxhayes Practice in Exeter, was passionate about helping patients in deprived circumstances. The practice had a taxi fund to assist patients at times of need. For example, a mother with an unwell child was given money for a taxi during a rain storm to avoid them having to get home by bus and the practice paid for the taxi for an elderly patient to attend the surgery.

Case study 2: Welbeck Road Health Centre in Derbyshire had set up a monthly patient singing group for patients over 60 years (and their carers) who had a chronic illnesses such as Alzheimer’s disease and memory problems. This activity was aimed at improving the mental wellbeing of older patients.

Case study 3: Lambeth Walk Group Practice in south London had initiatives to address social isolation. It organised a reading group and starting a gardening co-operative where patients could grow vegetables in the garden at the practice, which were then sold to local health and social care providers. The practice also organised an annual Christmas party for patients aged over 80, which was supported by local charities and provided food and a gift for each person. In addition, the practice had recently engaged with a voluntary organisation that hosted sessions at the practice to promote mental well-being through creativity.

Case study 4: Ash Trees Surgery in Lancashire actively supported patients and their carers to cope emotionally with care and treatment by inviting patients to attend a Listening Service. This was a free, confidential service held and facilitated by a volunteer chaplain listener every week. Appointments lasted up to 50 minutes and were available for patients who wanted to discuss any concerns for example, illness, the prospect of surgery, a difficult diagnosis or bereavement. Practice staff could suggest making an appointment, or patients could ask for an appointment for themselves. The service was promoted in reception.

Patient liaison/extra support for patients

Case study 1: Tong Medical Practice in Bradford, West Yorkshire had a dedicated member of staff in a patient liaison role. Their role included working with the patient participation group and local initiatives to improve services. They also contacted all bereaved patients and new mothers to offer support and advice. This staff member visited people at home to ensure they were receiving adequate support and had sourced equipment to enable one patient to be supported at home at the end of their life.

Case study 2: Radbrook Green Surgery in Shropshire employed a community and care co-ordinator (C&CC) who provided services to support vulnerable people. The C&CC ran and co-ordinated a support group for carers of people with dementia, a support group for patients with chronic fatigue and a bereavement support group. The C&CC had also established a compassionate communities group, which was a voluntary service that worked to reduce loneliness and social isolation. A team of volunteers offered one-to-one support for patients in their own homes, providing practical help or a befriending service.

Learning points:

  • Can you provide examples of compassionate practice? Are there any examples of when the practice has 'gone the extra mile' for patients?
  • If you are in a deprived area, have you established any new services or initiatives to help support patients?
  • How do you help support frail or elderly patients in your practice?
  • Do you have any specific processes or procedures for supporting recently bereaved patients/carers?
  • Are you involved with any projects that tackle social isolation? If not, do you know where these services are in your area and are you signposting them?

Fionnuala O'Donnell is a practice manager in Ealing, West London, and a CCG board member

CQC definition of a practice rated as outstanding for ‘Caring’

People are truly respected and valued as individuals and are empowered as partners in their care

Feedback from people who use the service, those who are close to them and stakeholders is continually positive about the way staff treat people. People think that staff go the extra mile and the care they receive exceeds their expectations.

There is a strong, visible, person-centred culture. Staff are highly motivated and inspired to offer care that is kind and promotes people’s dignity. Relationships between people who use the service, those close to them and staff are strong, caring and supportive. These relationships are highly valued by all staff and promoted by leaders.  

Staff recognise and respect the totality of people’s needs. They always take people’s personal, cultural, social and religious needs into account.

People who use services are active partners in their care. Staff are fully committed to working in partnership with people and making this a reality for each person. Staff always empower people who use the service to have a voice. They show determination and creativity to overcome obstacles to delivering care.

People’s individual preferences  and needs are always reflected in how care is delivered.  People’s emotional and social needs are seen as important as their physical needs

Outstanding practice examples for other key questions

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