Seaton Surgery

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that people were protected from abuse and avoidable harm.
At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.
 

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns, investigated safety events and used learning to continually improve. The provider had effective processes for reporting incidents, near misses and safety events, and a system for recording and investigating complaints. When things went wrong, staff were open and transparent, offered appropriate apologies and provided support. Learning from incidents and complaints led to improvements in care and service delivery. For example, following a document scanning error where confidential information was attached to the wrong patient record, the provider promptly identified and investigated the incident. Appropriate action was taken to rectify the error, and learning was shared with staff to strengthen document management and information governance processes.

People felt supported to raise concerns and said staff treated them with compassion and understanding. Representatives from the Patient Participation Group (PPG) told us the provider took concerns seriously and was responsive to feedback. They described being actively involved in service development and improvement initiatives. For example, PPG members contributed ideas to help reduce DNA (Did Not Attend) rates across the practice, which resulted in improvements in appointment utilisation.
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, ensuring safety was effectively managed and monitored. There were robust arrangements for processing information relating to new patients, managing shared care, and supporting continuity of care when patients moved between providers. Referrals and test results were reviewed and actioned safely and efficiently. The provider utilised an electronic clinical recall system to support routine patient monitoring, long-term condition reviews, and timely follow-up of investigations, helping to ensure continuity and coordination of care.

The provider worked with people and healthcare partners to understand what being safe meant to them and how best to achieve this. Safeguarding policies and procedures were in place, and staff had received safeguarding training appropriate to their roles. There was a designated safeguarding lead in place.

The provider maintained a register of vulnerable patients and responded appropriately to safeguarding concerns, working collaboratively with partner agencies to protect people from harm, abuse and neglect. However, we found that some adults living at the same address as children on the safeguarding register did not have the appropriate coding applied to their electronic records. The provider acknowledged this finding and told us they would review and strengthen their processes to ensure relevant household members were identified and coded appropriately in the future. Safeguarding was a standing agenda item at clinical and provider meetings, enabling concerns to be identified, discussed and escalated promptly. Staff also participated in external multidisciplinary team (MDT) meetings and maintained regular liaison with local authority teams and other partner organisations to support vulnerable patients and ensure safeguarding concerns were managed effectively.

The provider worked with people to understand and manage risks through a holistic approach to care. Emergency equipment was available, regularly checked and maintained, and staff were able to recognise and respond appropriately to deteriorating patients. Staff had completed training in sepsis awareness and basic life support and were confident in responding to medical emergencies. Patients were provided with information and advice about risks associated with their conditions and were supported to recognise warning signs and seek appropriate help if their condition deteriorated.

The provider detected and controlled potential risks within the care environment and ensured that equipment, facilities and technology supported the delivery of safe care. Appropriate arrangements were in place to maintain the premises, with regular health and safety risk assessments and audits undertaken to identify and mitigate risks. The provider maintained a comprehensive business continuity plan, which was regularly reviewed and updated to ensure the provider could respond effectively to unforeseen events and minimise disruption to patient care.

The provider generally ensured there were sufficient qualified, skilled and experienced staff to provide safe and effective care. There was an appropriate mix of clinical and non-clinical staff, who received regular support, supervision and development opportunities. Staff worked within their competencies and safe recruitment processes were in place. Training compliance was generally high across the provider. All staff had completed Part 1 of the Learning Disability and Autism training; however, Part 2 completion was lower at 42%. Following the assessment, the remaining clinical staff were booked onto the required training to achieve full compliance. During the assessment, further gaps were identified in staff records, including documentation of staff health information, immunisation records, references and employment history. The provider responded promptly and took immediate action to address these issues and strengthen governance arrangements.
Locum clinicians were sourced through the local federation, which undertook the necessary recruitment checks. New staff completed a structured induction programme and received ongoing support through regular supervision, annual appraisals and interim reviews. These arrangements enabled discussions on performance, training needs and professional development, helping to ensure staff remained competent, supported and able to deliver safe care.

The provider assessed and managed the risk of infection, with effective systems in place to prevent and control the spread of infection and to share concerns with appropriate agencies when required. They had a designated infection prevention and control lead, and all staff had completed relevant training. Cleaning arrangements were in place and monitored, and clinical waste was collected by a specialist waste disposal company. Risk assessments and audits were undertaken regularly, with actions implemented to mitigate identified risks. Leaders also carried out spot checks to provide ongoing assurance that infection prevention and control standards were maintained.

Most of the time the provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.
Clinical searches identified that medicines management and long-term condition monitoring were effective overall. Monitoring arrangements for Disease-Modifying Anti-Rheumatic Drugs (DMARDs) and other high-risk medicines were well established, and compliance with Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts was generally good.

However, some concerns were identified relating to missed or uncoded diabetes diagnoses, variable documentation of medication reviews, patients prescribed Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or antiplatelet medicines without appropriate gastroprotection, and some gaps in monitoring for patients prescribed Direct Oral Anticoagulants (DOACs). The provider reviewed all findings promptly, investigated affected records and took appropriate action where required. Some of the concerns were attributed to coding issues. Improvements were made to clinical oversight, coding, monitoring processes and prescribing safety systems, with additional safeguards introduced to support timely follow-up and reduce the risk of recurrence.

Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. Staff received regular training, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely. Medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.