New Barn Close 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 people were protected from abuse and avoidable harm.

This is the first inspection for this service since a change in its registration with CQC. This key question has been rated as good.

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.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. People felt supported to raise concerns and felt staff treated them with compassion and understanding. Representatives from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. During staff meetings, the whole team discussed and learnt from clinical issues. The provider had processes to record and investigate complaints. Staff apologised when things went wrong and gave people support. Learning from incidents and complaints resulted in changes which improved care for others.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Leaders had systems in place for processing information relating to new patients. Staff worked with other providers to deliver shared care when patients moved between services. Referrals and test results were managed in a timely way. Staff had a system in place to follow up urgent referrals where patients needed an appointment within two weeks.

Staff worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve this. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Staff shared concerns quickly and appropriately. Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations.

Staff worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs which was safe, supportive and enabled people to do the things which mattered to them. Staff were trained to recognise a deteriorating patient and knew what action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

Leaders had systems in place to detect and control potential risks in the environment. They made sure equipment, facilities and technology supported the delivery of safe care. Health and safety risk assessments and audits had been undertaken, and risks were addressed promptly. There was a business continuity plan in place which was monitored and reviewed.

Leaders made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care which met people’s individual needs. Staff training was mostly up to date, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence. However, not all staff had received training in recognising the symptoms of sepsis (a life-threatening illness caused by the body’s response to infection). Leaders identified this had not been added to the mandatory training for those staff required to do the training and rectified this immediately. Safe recruitment practices were followed and improvements to this meant staff had a comprehensive handbook to use and properly signed contracts of employment.

Staff assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The practice had a designated infection, prevention and control lead and all staff had had relevant training. Cleaning schedules were in place and followed.

Leaders and staff made sure medicines and treatments were safe and met people’s needs and preferences. They involved people in planning, including when changes happened. Staff followed protocols to ensure they prescribed all medicines safely. Staff received regular training and were competency assessed on medicines optimisation. Staff felt confident managing the storage, administration and recording of prescriptions and medicines, both in the clinical areas and the dispensary attached to the practice.

Staff followed protocols to ensure they prescribed all medicines safely, however the clinical searches which formed part of the assessment identified not all patients had been recalled for regular monitoring. For example, not all people with asthma who had received two or more courses of steroid treatment for a worsening of their asthma were followed up after 1 week. Leaders had followed up all missed monitoring before the onsite inspection and new protocols were in place to mitigate the risk of this happening in the future.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. There were suitable processes for staff to follow when dispensing medicines. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials (antibiotics and anti-fungal type medicines) issued by the provider was lower than local averages. There was a programme of regular audits of prescribing which focused on improving care and treatment.