South Grange Medical Group Practice Also known as South Grange Medical 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 looked for evidence that people were protected from abuse and avoidable harm. At the last assessment this key question was rated 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 provider had processes for staff to report incidents, near misses and safety events. Staff reported feeling comfortable raising concerns. Incidents were discussed regularly in clinical meetings.

While we saw examples of where learning had taken place as a result of incidents, the process to cascade learning and involvement with all staff could be further improved, as staff were sometimes unable to describe a recent incident or recent learning points. Managers encouraged staff to raise concerns when things went wrong. Staff felt there was an open culture. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Trend analysis was carried out on incidents and complaints to identify recurring themes.

The provider 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.

Regular multi-disciplinary team (MDT) meetings were held to review the care of patients with complex conditions or those nearing end-of-life, ensuring holistic, well-coordinated care. Referrals and test results were managed in a timely way. Clinicians followed established care pathways for diagnosis, treatment, and referral to specialist services.

The service had identified that delayed or incomplete referrals were their most frequent type of recorded incident and had introduced a change in consulting templates on the system which had improved this.

Referrals to secondary care, including urgent 2-week wait referrals for suspected cancer, were managed promptly on a risk basis, and appropriately followed up. Patients were given additional ‘safety netting’ advice, to call the practice within a certain timescale if they hadn’t heard, or their condition deteriorated. Communications from secondary care, such as discharge summaries, were processed efficiently to ensure continuity of care.

Reception staff were trained in care navigation, which supported them to direct patients effectively, based on their needs, and promote preventative healthcare through social prescribing.

Systems and processes were in place to respond promptly when concerns arose about abuse or neglect, and the practice aimed to work closely with partner agencies to ensure a coordinated approach. All staff had received safeguarding training appropriate to their roles and responsibilities and demonstrated a good understanding and awareness of safeguarding procedures, supported by clear safeguarding policies.

Staff were aware of who the designated safeguarding leads were for both adults and children and felt confident in escalating any concerns. Safeguarding alerts were added to the clinical record system.

Patients were informed of their right to request a chaperone, with visible notices in waiting and clinical areas to support this. Staff had received appropriate chaperone training where necessary. There were clear chaperone policies and procedures.

Care and treatment was delivered safely and appropriately. Patients were given advice on the risks related to their conditions with clear guidance on what actions to take if their health deteriorated.

Staff were provided with guidance and appropriate supervision to help them to support people living with long-term health conditions.

Emergency equipment including a defibrillator and oxygen was available and maintained.

Staff showed awareness of recognising signs of a deteriorating patient including ‘red flag’ symptoms, and knew what action to take, such as escalating to a GP. Staff described good communication between clinical and non-clinical teams and an open-door policy enabling efficient sharing of information.

The provider detected and controlled potential risks in the care environment. They made sure care equipment, facilities and technology supported the delivery of safe care. Health and safety risk assessments and audits including infection control and hand hygiene had been undertaken and risks identified had been addressed.

There was a business continuity plan in place which was monitored and reviewed.

The service operated from a building that provided appropriate facilities, including safe access for individuals with physical disabilities. The premises were clean and equipped with appropriate resources to support effective infection prevention and control.

Staff received training in all relevant health and safety areas, including fire safety, infection control, and environmental risks.

The provider had processes in place to make sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff received an appropriate role specific induction, with annual appraisals and ongoing informal check-ins. There were a variety of staff handbooks and induction policies to support safe and effective staffing.

Staff worked together well to provide safe care that met people’s individual needs. Staff described a supportive environment where they were able and encouraged to access a variety of training and development opportunities, including clinical and prescribing supervision where necessary. The practice was a training practice and supported GP registrars appropriately. Staff told us of a strong culture of supportive learning where support was easy to access.

There were a range of clinical and non-clinical roles within the practice. We found training was up to date, learning needs, performance and development of staff was managed appropriately, and staff were working within their agreed areas of competence.

Appropriate Disclosure and Barring Service (DBS) checks were carried out on recruitment and reviewed thereafter. The immunisation status for staff was recorded.

The provider 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 staff knew how to escalate any IPC related concerns. All staff had received relevant training and induction. IPC risk assessments had been conducted and audits were completed, with actions taken to mitigate risks.

The provider mostly made sure that medicines and treatments were safe and met people’s needs.

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 and were regularly competency assessed on medicines optimisation and safe prescribing. 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.

The provider had systems to manage and respond to safety alerts and medicine recalls. There was a prescribing policy in place. We saw examples of where actions taken had been recorded and patients contacted as required.

The overall system for monitoring and reviewing medicines was effective. Our clinical searches showed some small numbers of patients on certain anti-inflammatory medications were not also prescribed a medication to protect the stomach lining, which was not in accordance with best clinical practice. These have now all been rectified.

The practice had high prescribing rates of Gabapentin and Pregabalin, over twice the expected rate given the England average. These medicines can be associated with serious harm or lead to dependence; these medicines may also be misused or diverted to illegal use. The rates of these had remained higher than the average over a number of years. The practice continued to try to engage with patients to reduce use, and in recognition of the issue had recently employed a pharmacist to carry out medication reviews for this group of patients.