Fairfield PMS

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 inspection, we rated this key question as good. At this inspection, 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 learned to continually identify and embed good practice. Staff told us there was an open culture and they felt supported to raise concerns. Staff were able to share examples of incidents and learning arising from investigations of such incidents. Staff told us they were invited to meetings where significant events and complaints were discussed, we saw that these were standard agenda items recorded on meeting minutes.

Patients told us they felt confident the provider took concerns seriously and made improvements based on patient feedback. There was a system to record and investigate complaints, and when things went wrong, staff apologised and offered support. Learning from incidents and complaints resulted in changes that improved care for others.

The service worked with patients 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 patients 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 were managed in a timely way. Patients with an urgent cancer referral were contacted 2 weeks after their referral had been made, asking them to inform the practice if they had not yet had their appointment.

There were systems to ensure test results were managed appropriately. These were managed by the requesting clinician or the duty doctor in the requesting clinician’s absence.

The service worked with patients and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving patients’ 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 patients and acted on concerns, working in partnership with other organisations. The practice had an action plan to ensure safeguarding registers remained accurate and information was shared appropriately.

The service worked with patients to understand and manage risks by thinking holistically. They provided care to meet patients’ needs that was safe, supportive and enabled patients 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. 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.

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.

Staff had attended training on responding to emergency situations in general practice.

Fire drills were regularly carried out. The provider identified areas for improvement and developed action plans to improve safety.

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 the individual needs of patients.

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. Safe recruitment practices were followed.

Audits were regularly carried out on the prescribing of non-medical prescribers. Staff received feedback to support their continued development.

We reviewed 5 staff files and found incomplete immunisation history for 1 non-clinical staff member. Following our feedback, the provider shared details of an action plan detailing how they would ensure oversight of staff immunisations for both new and existing staff members.

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 (IPC) lead and all staff had completed relevant training. Staff knew the processes for raising concerns relating to IPC. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions were taken to mitigate risks.

The service made sure that medicines and treatments were safe and met patients’ needs, capacities and preferences. They involved patients in planning, including when changes happened.

Staff involved patients in reviews of their medicines and helped them understand how to manage their medicines safely. Patients knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. Staff followed protocols to ensure they prescribed all medicines safely, and ensured patients received all recommended medicines reviews and monitoring.

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. Oxygen was stored safely.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. This included new alerts, and the management of patients prescribed medicines with associated historical alerts.

Staff followed established processes to ensure patients prescribed medicines with specific risks received recommended monitoring. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our inspection confirmed this. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.