Faircross Health Centre

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 have looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question as Inadequate because systems and processes did not keep patients safe. For example, arrangements for medicines management, including safe prescribing, were not effective. The management of patients with long-term conditions was not robust, and there were concerns regarding recruitment practices and the oversight of staff training. Since then, the service has changed provider and these issues were rectified. At this assessment the rating has changed to Good.

This service scored 72 (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.

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 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 significant events, and when things went wrong, staff apologised and gave people support.

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. Referrals and test results were managed in a timely way.

The service regularly engaged in multi-disciplinary meetings to review and plan care for patients with complex conditions or those nearing the end of life. This included discussions with their Primary Care Network, and the wider community care teams.

The service worked with people and healthcare partners to better 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, safeguarding was a standard agenda item on all practice meetings.

The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations. Whilst the practice had no patients on the child safeguarding register, we saw examples of referrals for this and appropriate follow up, as well as staff from all levels referring potential at risk patients to the safeguarding lead.

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.

Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and knew of action to take, and all staff had completed sepsis training. 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. However, there were insufficient number of trained fire wardens and limited documentation for fire drills.

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. 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, with regular supervision, one-to-ones, peer review, team training and appraisals.

Safe recruitment practices were mostly followed; we reviewed a sample of staff files and found two files with no photographic identification and one file with no references.

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 practice had a designated infection, prevention and control lead and all staff had had relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

Medicines were stored securely and at appropriate temperatures.

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.

Our review of patient records showed that people taking medicines with specific risks were appropriately monitored before their medicines were prescribed. Regular medicine reviews, including for high-risk drugs, were carried out for patients to ensure their medicines were safe and appropriate to their needs.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued by the provider was lower than local and national averages. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.

Staff received regular medicines training, were assessed for competency in medicines optimisation, and felt confident in storing, administering, and recording medicines. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. From our review of clinical records, the provider had effective systems to manage and respond to safety alerts and medicine recalls.