The Medic Care 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

The practice had established and effective systems in place to manage medicines safely. Patients had been appropriately monitored and/or advised of potential risks relating to their prescribed medicines. There was good antibiotic stewardship actively monitored by the provider. There were not always effective triage systems in place to ensure patients were consistently assessed by the most appropriate clinician. Clinicians were overseen to ensure safe and effective practice. Staff had sufficient training and received regular appraisals to ensure patients received safe care and treatment.

The service encouraged staff to report concerns. Managers investigated incidents thoroughly. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated.

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.

Staff knew how to raise concerns and told us they were supported to do so. They believed leaders and colleagues were committed to investigating, resolving and learning from incidents. Where improvements were required, information, advice and guidance were shared verbally among staff to improve the safety and standards of care.

There were established systems in place to capture concerns from patients, staff, and partner services. Incidents and complaints were investigated in a timely and appropriate manner. Honest and transparent accounts were provided to people and where appropriate, lessons learnt and shared to improve the service.

Staff were able to provide us with examples of learning identified from incidents. For example, the provider had identified and arranged additional emergency response training to improve staff confidence and response in future events.

There were established and effective systems in place to listen, engage and work with people and their partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. The provider actively monitored referrals, admissions and discharges from services. Patient records correctly detailed prescriptions issued by secondary care.

Staff monitored peoples progress along care pathways to identify barriers to accessing and maintaining care, escalated risks to partnership forums for resolution where appropriate. We found there were systems in place to support people as they moved between services.

The practice had established and effective systems in place to safeguarding vulnerable adults and children. Records of people at a higher risk of harm, abuse, or exploitation due to various factors that may impair their ability to protect themselves were regular revised to ensure information was current and relevant. We saw children’s missed appointments had been appropriately followed up with primary and or secondary care services. This was overseen by an appointed safeguarding lead who contributed to multidisciplinary meetings.

Staff were trained in safeguarding. They understood, applied and adhered to Gillick competency (is often used to assess whether a child is mature enough to consent to treatment), Fraser guidelines (used specifically for children requesting contraceptive or sexual health advice and treatment) and the Mental Capacity Act. Staff had access to adult and children safeguarding leads within the practice and could also escalate concerns externally if required. Staff told us they worked regularly and collaboratively with partner health and social care service coordinate services to support and met individual’s needs.

There were established and effective processes in place to support the early recognition and timely response to risks. Staff told us they invested in getting to know their patients so they could help understand and supporting them to manage their health.

People told us they were involved in decisions relating to their care. They were supported to identify and respond to changes in their health and signposted to support services appropriate to their personal care.

There were established and effective systems in place to identify, manage and mitigate risks to people. For example, the practice had conducted environmental risk assessments (including legionella testing and portable appliance testing) to ensure staff and people were safe and revised them annually or more frequently in response to changes. Maintenance contracts were in place to maintain the accuracy of equipment (calibration), scheduled safety checks were conducted on the fire alarm system, emergency lighting and equipment. Staff had been Disclosure and Barring checked (a way for employers check your criminal record, to help decide whether you are a suitable person to work for them) or risk assessed.

People told us they had undertaken annual training in health and safety and practices procedures. Staff had been trained in emergency first aid. Staff could alert colleagues to concerns such as verbal or physical abuse via their clinical system whilst providing care or support to patients and this was regularly tested.

We found there was assisted entry into the premises. People had access to chairs with arms in the waiting areas to assist those with limited mobility. There were appropriate child changing facilities with appropriate restraint belt to mitigate the risk of the child falling whilst being changed. Clinical staff used single use items and had access to body fluid spillage kits to mitigate the risk of infection to patients. Information was displayed throughout the premises promoting dignity and respect to people and the standards of conduct expected.

Staff and leaders understood the recruitment and disciplinary processes and emphasised their commitment to support staff. The management team ensured processes were reviewed and applied appropriately to ensure there is no disadvantage based on any specific protected equality characteristic.

Staff told us appropriate staffing levels and skill mix was maintained to make sure people received consistently safe, good quality care that met their needs. Staff told us they found supervisions supportive and had professional development opportunities.

We found safe recruitment practices were employed when appointing clinical and non-clinical staff, including agency staff. Staff had suitable experience or were supported and assessed as competent to carry out their role. Staff were required to complete mandatory training and had opportunities to complete further training relevant to their role. Staff performance and conduct was monitored, and where appropriate poor performance was addressed through supervision and appraisal. Clinical staff maintained their professional revalidation.

There were established and effective systems in place for identifying, assessing and managing the risk of infection, which is in line with current relevant national guidance. Staff told us they had been appropriately vaccinated to mitigate the risk to them and others of infection. They received training in infection prevention control and additional refresher information. They had access to barrier controls and gloves, aprons and masks to mitigate the risk of infection to people. Staff explained to us how they triaged and managed patients with potentially contagious diseases.

The reception desk was high to mitigate risks of infection to staff. Cleaning schedules were in place for rooms and equipment and had been appropriately completed. We found all handwash dispensers were full and there were appropriate hand drying arrangements in place. Additional checks were conducted by the management team to ensure standards for cleanliness were maintained. Cleaning items had appropriate processes in place to control substances hazardous to people’s health.

A lead GP oversaw the management of medicines within the practice to ensure safe prescribing practices. Best practice and guidance were shared with staff when received and formally during clinical meetings to promote best practice.

Medicines were stored appropriately in accordance with cold chain procedures to maintain their integrity. We found up-to-date information about people’s medicines was available, particularly when they move between health and care settings. People were involved with assessments and reviews about the level of support they need to manage their medicines safely and to make sure their preferences are included.

There were established and effective systems in place to periodically search prescribing practices to identify potential risks to patients. Patient reviews were up to date and high-risk medicines were effectively monitored. Medicines and Healthcare Products Regulatory Agency alerts (providing alerts, recalls and safety information on drugs and medical devices) were reviewed and actioned.

People were signposted to additional support services to help them with their condition e.g. dietary or smoking cessation.