Blossom Health Gosport

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 practice since its registration with CQC. This key question has been rated as Good.

Safety was a top priority, and staff took all concerns seriously. When things went wrong, staff acted to ensure people remained safe. Managers investigated all reported incidents to reduce the likelihood of them happening again. Staff were able to share an example of a recent significant event, action taken and lessons learned.

Staff were confident in responding to safeguarding concerns and had received the level of training relevant to their role. The practice ensured workforce planning arrangements were in place to provide safe, high-quality care and staff had access to training and development opportunities to support them in their role.

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 practice had a proactive and positive culture of safety, based on openness and honesty. 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 confirmed safety was a top priority. The provider had processes for staff to report incidents, near misses and safety events. For example, we reviewed significant events relating to both local and national incidents, such as an unexpected IT system outage. This triggered the review of the practice business continuity plan. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support.

The practice 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 new patient information. The practice worked with other providers to deliver shared care and when patients moved between services. Referrals and test results were managed in a timely way.

Safeguarding policies were in place. Staff were trained in safeguarding procedures and had received safeguarding training appropriate to their role. Staff were able to provide us with examples of when they had shared concerns quickly and appropriately. There was a designated safeguarding lead. The practice kept a list of vulnerable people and worked with other organisations to address any concerns.

The practice 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 told us they could recognise signs of a deteriorating patient and knew what action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

The practice used a system to code patients based on their communication needs and health conditions. Patients identified as higher-risk had a named GP, dedicated clinics, and the option of longer appointment times. Audits were conducted regularly to ensure patients were coded correctly and kept up to date.

There were systems for sharing information with staff and other agencies to enable them to deliver safe care and treatment. The practice had processes to monitor delays in referrals. For example, we saw they conducted audits to ensure ‘two week wait’ (2WW) cancer referrals had been booked with secondary care providers (2WW cancer referrals are urgent referrals used to investigate symptoms to detect cancer).

The practice 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. For example, we reviewed risk assessments relating to fire safety, legionella and health and safety within the premises. There was a business continuity plan in place which was monitored and reviewed. Staff we spoke with were aware of the business continuity plan.

Staff felt 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 clinical and non-clinical roles in the practice. We found training was up to date, learning needs and development of staff was managed appropriately, and staff were working in their agreed areas of competence. However, we found that the practice did not have evidence of a DBS check or occupational health history for two members of non-clinical staff. We raised this with the practice and following assessment, they provided assurance of these recruitment checks.

The practice 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 (IPC) lead and all staff had received relevant training. IPC risk assessments had been conducted and audits were completed, with actions taken to mitigate risks.

The practice 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. Where shortfalls were identified, they acted promptly to ensure patients received the necessary monitoring.

Our remote clinical searches identified the majority of people received the recommended medicine reviews and monitoring. However, following our remote clinical searches of patients prescribed high-risk medicines, we noted that not all patients prescribed Aldosterone (a diuretic medicine used for cardiac conditions) had received monitoring in line with national guidance. We fed back our findings to the practice who acted immediately to address these shortfalls. They added this search function to their routine recall audits and following assessment they told us that all patients affected were recalled for routine monitoring.

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 in managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely.

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 and completed required safety risk assessments. We saw that staff monitored fridge temperatures and had a clear process in place for managing inconsistencies in temperature range.