Cannock Road Medical Practice

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 service had a positive culture of safety, based on openness and honesty. They listened to concerns about safety, investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Patients said that feedback was welcomed and they felt supported if they needed to raise concerns.

Complaints, patient concerns and feedback were dealt with in a consistent and fair manner. Patients could raise concerns through various methods such as email, letter, complaint form or verbally to staff. All concerns were processed using a template to ensure the process was consistent, recorded and reviewed correctly. Patients were signposted to other organisations, should they wish to raise their concerns further.

The service had a positive culture of safety, based on openness and honesty. They listened to concerns about safety, investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.
Patients said that feedback was welcomed and they felt supported if they needed to raise concerns.
Complaints, patient concerns and feedback were dealt with in a consistent and fair manner. Patients could raise concerns through various methods such as email, letter, complaint form or verbally to staff. All concerns were processed using a template to ensure the process was consistent, recorded and reviewed correctly. Patients were signposted to other organisations, should they wish to raise their concerns further.
 

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. 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. The service shared concerns quickly and appropriately.

There was clear safeguarding information displayed in key work areas, and a detailed safeguarding handbook to support staff in keeping people safeguarded from harm or abuse. The handbook contained information and guidance on all aspects of safeguarding and was easy to navigate to access information as required.

Staff were knowledgeable and confident in their roles and responsibilities in safeguarding and could explain actions to take and understood the responsibilities of the safeguarding lead and the leadership team.

Training had been completed in a timely manner at the level suitable for each role, with opportunities to discuss any learning in staff meetings.

The service maintained a list of vulnerable people and acted on concerns working in partnership with other organisations, as well as system alerts to identify people at risk of harm or abuse including household contacts. The service also used prompts to ensure correct information was recorded.

There were systems in place to respond to concerns and act on correspondence. For example, if a vulnerable child or adult did not attend an appointment with the service or another health service appointment.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

All staff had completed training in basic life support. Staff could recognise a person with a deteriorating condition and knew of actions to take. There was information displayed in the form of posters to support this knowledge, such as symptoms that might be a sign of sepsis, heart attack or a stroke.

Patients felt they were given time and information to understand risks, the service thought about people with learning disabilities and included visual aids as part of the health assessment, such as diagrams and easy read to explain health screening.

The service had emergency equipment available, which was well maintained and stored in a central position and accessible to staff when required. The kit had razor, scissors and a towel missing, which would potentially be required quickly in an emergency, these items were available onsite. A risk assessment including the effectiveness of emergency kit content and storage had not been completed. Following the onsite assessment the service has provided evidence that the items have been placed in the kit and actions taken.

The service did not always detect and control potential risks in the care environment. They did not always make sure equipment and facilities supported the delivery of safe care.

We completed a sample check of items classed as sundries. These are items that are used as part of patient treatment such as needles, dressings and test strips. We found that 4 out of the 10 items were out of date, there was no clear process for checking these items. This was highlighted to the providers during the onsite visit.

The storage of cleaning materials that could be hazardous and potentially cause harm was well maintained and included the correct documentation for the cleaning materials, such as safety sheets.

The correct signage, to show the potential hazard, was not displayed, this was brought to the attention of the provider and immediately rectified during the onsite visit.

Medical equipment was sample checked for assurance that testing had been completed and items were in good working order. Most items checked were in good working order and had received the correct testing, we identified items which didn’t meet the required assurance checks, such as a blood pressure machine. Following on from the assessment the service had provided evidence that actions had been taken to ensure equipment, including items used by Primary Care Network (PCN) clinicians, were maintained as per guidelines.

Contracts were in place to ensure the premises were maintained. Fire safety checks and fire drills were completed routinely. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed. There was a business continuity plan in place which was detailed and considered different emergency situations. Staff training relating to health and safety was up to date.

The service 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 that met individual needs.

There were a range of clinical and non-clinical roles within the practice. We found training was up to date, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence. Safe recruitment practices were followed. There were processes in place to gain assurances that all staff who worked under the direction of the service, including those employed by the PCN had been recruited safely.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and understood the importance of sharing concerns with appropriate organisations promptly.

The service had a designated infection, prevention and control (IPC) lead, who completed audits and was able to demonstrate how the role supported and guided staff in relation to IPC.

An IPC handbook was accessible to all staff detailing relevant information and guidance. Key information was displayed, such as hand wash techniques and actions to take if an injury occurs involving a sharp item, such as a needle.

The environment and equipment were visibly clean, with cleaning schedules in place and followed.

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Staff stored medical gases, such as oxygen, safely. Medicines which required storage within a fridge to maintain the required temperature were well maintained and controlled. Fridge temperatures were recorded correctly and actions taken if required.

The temperature of areas where medicines requiring storage at ambient temperatures, between 15 and 25 degrees Celsius, were not being monitored. The service policy relating to medicines stated this process occurred daily. Following on from the assessment the provider submitted evidence that this process has been reviewed and was being completed as per policy.

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 antibiotics issued by the service was in line with national targets.

Prescribing of medicines that could lead to dependency or potential harmful effects were monitored to ensure safe prescribing and patients understood the risks and knew how to take the medicine correctly. The prescribing of these medicines was in line with national targets. We also saw examples of patients being supported to reduce doses and avoid long term dependency.

Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms.

Staff had the necessary authorisation to administer medicines, including Patient Group Directions and Patient Specific Directions.

Prescription stationery was securely stored and processes were in place to monitor and record the use of these.

We reviewed whether the service was acting on Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts. As part of this, we examined a safety alert relating to Valproate, a medicine used to treat epilepsy. All records in the sample had the correct review, advice and patient acknowledgment recorded.

We completed a clinical assessment of medicine reviews. This showed that the way these were documented needed improvement. Some records flagged as a medicine review contained little information, making it unclear whether a full and meaningful review had taken place for people who regularly took medicines. The provider acknowledged this issue and planned to improve the way records were flagged and ensure detailed documentation was completed by all clinicians.

We carried out checks on how well the service reviewed people who were routinely prescribed medicines.
We looked at records for people prescribed bisphosphonates, a medicine that helps strengthen bones and reduce the risk of fractures. Of the five randomly selected records, none showed the correct review or actions taken. The service later provided evidence to show what actions they took after our assessment.

We also reviewed records for people prescribed aldosterone antagonists, a medicine used to treat high blood pressure and reduce fluid retention. Of the five randomly selected records, all had the correct clinical review recorded, or a clear reason for any different action.