Barrow Health Centre

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• 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 staff protected people from avoidable harm and made sure care was delivered from environments that were clean and well maintained. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

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.

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 detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
The service had systems and processes in place to maintain a safe environment for people using the service. Health and safety audits and risk assessments were undertaken and reviewed to ensure potential hazards were identified and addressed. Leaders maintained oversight of actions arising from audits and monitoring activity.
The premises were visibly clean, well maintained and suitable for the services delivered. Consultation and treatment rooms supported patient privacy and dignity. The building was accessible and included designated disabled parking spaces, accessible toilet facilities, hearing support arrangements and level access throughout the premises.
The service had arrangements in place to ensure equipment, facilities and technology remained safe and fit for purpose. Clinical equipment was calibrated and maintained appropriately. Emergency equipment and medicines were available, routinely checked and found to be within expiry dates. Records demonstrated that regular checks were undertaken on oxygen supplies, resuscitation equipment and emergency medicines to ensure readiness in the event of an emergency.
The service had a business continuity plan and arrangements to respond to emergencies or unexpected disruption. Fire safety systems, health and safety processes and maintenance arrangements were reviewed regularly to support the continued delivery of safe care.
 

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.
Systems were in place to ensure staff remained competent in their roles. Appraisals were completed annually, mandatory training was monitored through an electronic system, and leaders reviewed training compliance regularly. Staff also had access to protected learning time and role specific training opportunities.
The service followed safe recruitment procedures, including appropriate employment and Disclosure and Barring Service (DBS) checks where required. Leaders maintained oversight of recruitment records and staff compliance.
Staffing levels and skill mix were regularly reviewed to support effective service delivery. Leaders planned workforce capacity in advance and had arrangements in place to provide additional cover where required. Staff told us they felt supported and understood their individual roles and responsibilities within the practice team.
 

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 systems to prevent, identify and manage infection risks. Infection prevention and control (IPC) policies and procedures were available, and staff had completed training appropriate to their role.
The premises and equipment reviewed during our assessment were visibly clean. Cleaning schedules, audits and monitoring processes were used to support oversight of cleaning arrangements. The service had an identified IPC lead who maintained oversight of IPC activities and risk assessments.
Staff vaccination records were maintained, and infection-related concerns were escalated appropriately where required. Leaders monitored IPC arrangements to ensure risks were identified and managed in a timely manner.
 

The service did not always make sure that medicines and treatments were[SS1.1] safe and met people's needs, capacities and preferences in line with national guidance.
The service had systems in place to support the safe prescribing, administration and monitoring of medicines. Medicines management was supported through multidisciplinary working, clinical oversight and regular review processes. Prescribing data reviewed as part of the assessment was generally in line with local and national comparators.
Clinical searches identified some inconsistencies in medicines monitoring, documentation and follow-up arrangements. Searches reviewing patients prescribed disease-modifying anti-rheumatic drugs (DMARDs) found that monitoring requirements and shared care arrangements were not always documented consistently. Clinical searches relating to lithium monitoring identified gaps in calcium monitoring for some patients, and records relating to medicines subject to national safety alerts did not always demonstrate that documentation requirements had been completed in line with guidance.
Following the assessment, the service undertook a comprehensive review of the findings and demonstrated that appropriate clinical management had occurred in many cases. Leaders completed additional patient reviews, arranged outstanding monitoring, strengthened recall processes, reviewed prescribing arrangements and shared learning across the practice. The service developed a detailed action plan and implemented governance measures to improve monitoring, documentation standards and medicines oversight.