Adelaide 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, this key question was rated Inadequate. During this assessment, we found evidence of significant and wide-ranging improvements, including the implementation of a robust recruitment system and the development of a positive learning culture. As a result, the rating has improved to 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. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical issues. Staff felt there was an open culture, and that safety was a top priority.

The provider had processes for staff to report incidents, near misses and safety events. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that 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.

The service was part of the Primary Care Network (PCN) and attended regular meetings with other local services to share and discuss information about patient care and treatment. This included discussions about people on the service’s palliative care register.

Referrals were well managed, with systems in place to provide assurance. For example, two-week wait referrals were tracked to make sure they had been actioned and completed.

Test results and tasks were managed in a structured way, with systems in place to ensure urgent results were reviewed and actioned promptly to ensure peoples’ care and treatment requirements were met.

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.

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 safeguarding training was up to date, with all non‑clinical staff trained to level 2 and all clinical staff to level 3. Training was reinforced through regular discussion, reflection and learning, ensuring safeguarding knowledge was actively applied in practice.

The practice showed good multi-agency working, with safeguarding leads regularly working with health visitors, and other partner organisations. They took part in multidisciplinary and case review meetings, which helped identify health, social, and emotional concerns at an early stage. This supported timely action and a coordinated approach to reducing risk and improving outcomes for children and families.

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.

Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and knew of action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated

A duty doctor was always available for staff to discuss any concerns around patients they had.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Contracts were in place to ensure the premises were maintained. 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 monitored and reviewed.

All records observed showed electrical equipment had been appropriately calibrated, and safety tested in line with regulations. Safety alerts relating to equipment were effectively disseminated to relevant staff and acted upon in a timely manner, ensuring risks were minimised.

Appropriate systems were in place for safe storage of blank prescription stationary; there were appropriate security arrangements in place to ensure that access to the dispensaries at all sites remained secure.

Arrangements for accessing emergency equipment were robust and well embedded. Effective systems were in place for the checking and monitoring of emergency equipment and medicines. The practice held all recommended items, including oxygen and an automated external defibrillator (AED).

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 people’s individual needs.

There were a range of clinical and non-clinical roles within the practice. All training was up to date, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence.

Staff were supported through protected learning time, with the practice regularly holding dedicated learning sessions to support development, shared learning and continuous improvement. These sessions facilitated team development, shared learning, governance discussions and reflection on significant events, quality and safety.

The provider made sure that staff were suitable for employment. Policies for appraisals and safe recruitment practices including Disclosure and Barring (DBS) and registration checks were in place. We reviewed 5 personnel files and found appropriate checks such as previous employment record, immunisation status and proof of identity checks had been completed.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

During our onsite visit, the service's premises was noted to be visibly clean, uncluttered, and appropriately maintained. The practice’s infection prevention and control lead conducted regular risk assessments and audits to ensure compliance and took action where necessary to mitigate any identified risks. Staff had completed relevant training in infection prevention and control.

There were cleaning schedules and guidance in place. A sample of cleaning records showed that cleaning was completed routinely and recorded.

The service 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.

Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. Medicines were stored securely and at appropriate temperatures. Fridge temperatures were routinely monitored and recorded electronically, any gaps could be identified and assurance provided by downloading data from a second temperature recording tool.

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.

We carried out a series of searches on the practice's clinical systems as part of this assessment. We reviewed the clinical records of patients who had been prescribed medicines requiring routine monitoring, we found that they had manage appropriately and line with best practice.

For example, our clinical searches identified 59 patients who had been prescribed a medicine commonly used to treat conditions such as rheumatoid arthritis and psoriasis. As this medicine can cause serious side effects, regular monitoring is essential. We reviewed 5 patient records and found that 1 patient was overdue for monitoring, while the remaining 4 patients had received appropriate monitoring in line with recommended requirements. Appropriate action was taken by the practice for the overdue patient, and the patient was contacted immediately.

The service used Patient Group Directions (PGDs) to support the safe administration of immunisations. Staff using PGDs demonstrated a good understanding of their use, and documentation had been appropriately authorised and signed.