BRENTFORD FAMILY 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.

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

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 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. We spoke to 7 members of the Patient Participation Group (PPG) who told us the provider took concerns seriously and proactively made improvements to the service. Managers encouraged staff to raise concerns when things went wrong. We saw from meeting minutes that the whole team discussed and learnt from incidents, safeguarding concerns, and complaints. Staff we spoke to told us there was an open culture, and that safety was prioritised. The provider had processes for staff to report incidents, near misses and safety events. There was a system to record and investigate complaints, and we saw evidence that 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.

There were systems in place for processing information relating to new patients. The service worked with other providers to deliver shared care and when patients moved between services. Referrals and test results were managed in a timely way. The provider had a failsafe system for managing urgent referrals.

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 trained in safeguarding procedures to the level appropriate for their role. For example, clinical staff were trained to level 3 and non-clinical staff were trained to level 2. The service maintained a list of vulnerable people and acted on concerns working in partnership with other organisations.

However, on the day of the inspection, we found that safeguarding pop-up alerts were not functional on the patient record and family members were not linked to those patients with a safeguarding concern. Following the site visit the provider immediately rectified these issues.

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. All staff had undertaken training on Sepsis and protocols for dealing with suspected cases of Sepsis were displayed throughout the practice. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

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.

However, there were some outstanding actions identified from health safety risk assessments that were the responsibility of NHS property services that the practice had not followed up. Following the site visit the provider sent us evidence these had been acted on.

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. We reviewed the recruitment and training files of 6 staff members and 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.

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.

The practice had a designated infection, prevention and control lead and all staff had had relevant training. The practice appeared clean on the day of our site visit and cleaning schedules were in place and followed. Infection, prevention and control audits were completed, and actions taken to mitigate risks. The staff files we reviewed showed that they had received the relevant immunisations such as hepatitis B.

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 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 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. Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring. Medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Waste medicines were recorded and disposed of appropriately including medicines returned by patients. Staff stored medical gases such as oxygen safely. The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes. The service demonstrated effective antimicrobial stewardship. For example, the percentage of antibacterial prescriptions prescribed was below the England average. The provider had carried out medicine audits to ensure prescribing was in line with recognised standards. Our clinical searches carried out as part of the inspection did not identify any significant issues and minor issues identified were addressed immediately by the practice.