Alton 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 people were protected from abuse and avoidable harm.

At our last assessment,we rated this key question as good. At this assessment,the rating has changed to requires improvement.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service had arrangements with the landlord to maintain the premises and ensure that equipment, facilities, and technology supported the delivery of safe care. Required checks, including gas safety, portable appliance testing (PAT), and equipment calibration, had been completed in a timely manner. Annual fire safety drills were undertaken and learning shared with staff.

On the day of our onsite assessment, the service was unable to demonstrate how it assured itself that landlord-led checks and risk assessments had been appropriately acted on.Following our assessment, they contacted the landlord for evidence of the actions taken and sent these to us to demonstrate how safety within the practice environment was maintained.In particular,a risk assessment for the storage of oxygen;remedial work completed following the unsatisfactory 5-year Electrical Installation Condition Report; actions taken to address issues identified in the fire risk assessment; and evidence that blind cords would be replaced. They also established a memorandum of understanding between the landlord and the service to ensure quarterly sharing of information.

Effective systems were in place to track prescription stationery throughout the practice. However, arrangements to securely store prescription stationery within the dispensary printer overnight were not in place. In addition,a risk assessment had not been completed to mitigate risks associated with a contracted member of staff having sole access to the dispensary. Following our assessment,the provider sent us a risk assessment to mitigate potential risks for lone working in the dispensary and the actions taken to securely store prescription stationery at all times.

The service had a business continuity plan outlining how it would respond to disruption of the service. This was in the process of being updated.

The service made sure there were enough qualified,skilled and experienced staff.The service employed a range of clinical and non-clinical roles, which included GPs, nurses and dispensers. Leaders ensured staff were up to date with their training which the service had deemed mandatory and operated within their agreed areas of competence.

However, a system of auditing the prescribing of non-medical prescribers and records of clinical supervision were not always in place. Following our assessment the provider implemented a non-medical prescribing and clinical supervision policy which contained clinical supervision and audit templates.

The service did not always follow safe recruitment procedures in line with national legislation. In particular, the completion of risk assessments for dispensers when Disclosure and Barring Service (DBS) checks had not been completed. We found that risk assessments where a full employment history, with a written explanation of any gaps in employment, were not available in 2 of the staff files we looked at. Following our assessment the service sent us a new starter checklist they had developed which included the need to check for gaps in employment histories.

Some infection control processes were in place to manage the risk of infection and to detect and control the risk of it spreading.The service’s infection prevention and control (IPC) lead conducted regular risk assessments and audits to ensure compliance and acted where necessary to mitigate any identified risks.For example,the IPC audit identified that some chairs in clinical rooms were not wipeable. In response, these were replaced with wipeable seating. During our onsite visit, the service's premises and a sample of equipment reviewed were found to be visibly clean.

On the day of our assessment,the service was unable to demonstrate that a formal policy and process was in place to mitigate risks associated with carpeted areas in corridors and 2 consultation rooms.For example, there was no clear guidance on cleaning frequency or the management of contamination, such as body fluids or spillages.Following our assessment, the provider sent us evidence of when the carpets had been cleaned by the landlord.While staff had completed infection prevention and control training, they reported not receiving training on the use of spill kits.

The service had cleaning schedules available, which outlined how clinical staff should clean the building and its equipment. The service demonstrated how these were monitored for completion to maintain oversight of clinical cleaning arrangements.

Following our assessment, the provider sent us cleaning schedules domestic staff followed.However, the cleaning company stated they did not require their staff to complete cleaning check lists. Measures, such as documented spot checks,to demonstrate compliance with the cleaning schedules were not in place.

A record of staff immunisations against potential health care acquired infections,in line with national guidance,was not always available and risk assessments had not always been completed where it was appropriate to do so. For example,where a full immunisation history for a member of staff was not available. Following our assessment the provider sent a list of all the missing staff immunisations and a suite of risk assessments to mitigate potential risks.However, it was not clear which risk assessment related to which member of staff or if appropriate risk assessments had been shared with staff.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.