Essex Way 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, we rated this key question as Good. At this assessment, the rating remains the same.

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. Representatives from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. Managers encouraged staff to raise concerns when things went wrong.

During staff meetings, the whole team discussed and learnt from clinical issues. For example, incidents and concerns were discussed at practice meetings and the learning was shared with all staff, including through using a practice learning book and newsletters. Feedback from the Primary Care Network (PCN) was also considered where this could benefit the practice.

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.

There were systems in place for processing information relating to people who were newly registered at the service. The service worked with other providers to deliver shared care and when people moved between services. Referrals and test results 9002634 V2 were managed in a timely way. For example, referrals were logged and monitored including 2-week wait referrals, with outcomes recorded and reviewed.

The service also worked with PCN services, secondary care and community services to support patients moving between services. They shared relevant information about people with other services through Multi-Disciplinary Team (MDT) meetings, including community services and social prescribing, with meeting minutes retained to support continuity and coordinated care.

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.

For example, safeguarding alerts and relevant coding were used on people’s records to help staff identify vulnerable people and respond appropriately to concerns. The service worked with external safeguarding and other healthcare professionals when required, and safeguarding concerns were discussed within practice meetings to ensure appropriate action, follow-up and learning.

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.

For example, the service considered people’s individual circumstances and wider needs when managing risks. People and their carers were involved in discussions about their care, with care plans used where appropriate. Staff also worked with social prescribers and other Primary Care Network professionals to address wider social needs and arranged home visits for people who were unable to attend the service.

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.

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

For example, the service regularly monitored health and safety risks through appropriate risk assessments and checks. Fire safety arrangements included regular fire alarm testing, fire drills, identified fire marshals and a fire grab bag containing essential equipment to support a safe response in an emergency. Equipment and premises were maintained and actions identified through risk assessments were followed up.

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.

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. The service followed safe recruitment procedures when employing staff, which was in line with national legislation. This included identity checks, review of qualification, obtaining professional references and Disclosure and Barring Service (DBS) checks. Checks of professional registration of clinical staff were made at recruitment and on an ongoing basis.

We 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. The service used a range of clinical staff and worked with the PCN to maintain appropriate staffing and skill mix. Nursing cover was discussed and planned across the week with additional support available through the PCN, helping maintain continuity of the service.

Staff competency and experience were discussed and documented at meetings, with annual appraisals and ongoing supervision in place. Clinical staff were supported through planned supervision and auditing of their work and identified training needs were addressed. Where performance concerns were identified, findings were reviewed with the relevant staff, with additional support or training provided where required.

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 service had a designated infection prevention and control (IPC) lead and all staff were aware of their responsibilities regarding IPC. Staff had completed training to the appropriate level. Cleaning schedules, cleaning equipment, wipes and spill kits were readily available. Staff were aware of the IPC lead and the procedures to follow if any infection-related concern arose. Risk assessments and audits were completed, and actions taken to mitigate risks.

During our review of staff records, we noted non-clinical staff did not all have appropriate immunisation to clean up spilt bodily fluids. We raised this with the provider who took immediate action. They reviewed this area and the service advised only clinical staff would be involved in the cleaning or management of spilt bodily fluids and provided assurance clinicians were on site when people were using the service. The IPC policy was subsequently reviewed and updated to reflect this decision with assurances around what staff should do if there was no clinical member of staff on the premises. This was communicated to both clinical and non clinical staff with actions recorded.

Staff vaccination records were maintained and reviewed. The service followed appropriate guidance when managing infection-related incidents and concerns and had arrangements in place for escalation and referral where required. The service demonstrated that identified IPC risks were discussed, acted upon and used to improve the service and protect both staff and people using the service.

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.

The service had a prescribing policy covering acute, chronic and repeat prescribing. Staff used clinical system searches, alerts and prompts to support safe prescribing and ensure that people requiring regular monitoring were identified and reviewed within the recommended timescales. For example, prescribing data showed that the practice prescribed antibiotics at a lower rate than the expected comparator for the service.

The provider managed medicines safely and took account of people’s individual needs and preferences. 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 if 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.

The service worked closely with the Primary Care Network (PCN) pharmacy team to support medicines optimisation. Medication reviews were regularly undertaken, and the reviews we sampled were detailed and involved contact with people. We received positive feedback about the quality of these reviews.

The service used clinical searches, electronic alerts and audits to identify people who required medicines monitoring or further review. This included monitoring of medicines that require regular blood tests or other clinical checks.

The provider responded to medicines safety alerts and discussed these through regular practice meetings. The PCN pharmacy team also supported the service with ongoing monitoring of prescribing and medicines safety.

Medication reviews undertaken by the PCN pharmacy team were detailed and involved contact with people directly with positive feedback received about the quality. Audit, medication reviews and prescribing data was used to identify learning and agree actions.

Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring.

Medicines including controlled drugs were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. 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. Staff managed prescription stationery appropriately and securely.