The Potteries

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 a positive culture of safety and leaders encouraged staff to raise concerns when things went wrong. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience and received training and regular appraisals to maintain high-quality care. The practice effectively used clinical record reviews to identify patients at high risk of harm.

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 to identify and embed good practice.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. 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.

Information reviewed demonstrated that people had opportunities to provide feedback, and they knew how to make a complaint. Learning from incidents and complaints resulted in changes that improved care for others. We reviewed significant event and a complaint in detail and found that a thorough investigation had been completed, and changes had been implemented to avoid issues occurring again.

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. We saw evidence that suggested that referrals and test results were managed in a timely way.

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 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.

DBS checks were in place for all staff working at the practice (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

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 them to do the things that mattered to them.

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. All staff were trained in basic life support. Reception staff were aware of actions to take if they encountered a deteriorating or acutely unwell patient and had been given guidance on identifying such patients.

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 inspections and audits had been undertaken and risks identified had been addressed. There was a business continuity plan in place which was monitored and reviewed.

There were policies and procedures in place for the management of health and safety. Fire safety policies were reviewed regularly, and staff were aware of how to access these. Fire marshals had undertaken additional training for the role. Systems were in place for the regular checks of fire alarms, extinguishers and fire evacuation procedures.

During our site visit we noted that equipment, facilities and technology supported the delivery of safe care. Regular checks were carried out on the emergency medicines and equipment held at the premises.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked well together.

We found all staff training and learning needs and their development was managed appropriately.

All newly employed staff had completed an induction to ensure they were competent in carrying out their role. We reviewed 5 personnel files and found appropriate 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.

We noted that all staff had had completed their infection prevention and control training (IPC) training. The practice had a designated IPC lead. There were dedicated cleaning staff who worked to cleaning schedules. Risk assessments and audits were completed, and actions taken to mitigate risks.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

The practice had robust recall processes in place, to ensure patients were prompted when they needed a medicine reviews, reflecting its strong focus on patient safety. A variety of communication methods were used to engage with patients, including text messaging, letters and telephone calls.

Staff received regular training, were competency assessed on medicines optimisation. They felt confident managing the storage, administration and recording of medicines.

We noted that some of the PGD’s (Patient Group Direction) were not completed appropriately to authorise staff to administer vaccinations. However, this was rectified during the assessment. (PGD’s allow specified health professionals to supply and/or administer medicine without a prescription or an instruction from a prescriber.)

Medicines, including vaccinations, were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines. 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. Prescribing data we reviewed part of our inspection confirmed that staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes.