Sunlight Group Practice Also known as Parkfield 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 assessed all quality statements under this key question. The rating given is Good.

The service promoted a positive learning culture where most staff felt able to speak up and raise concerns. Leaders prioritised safety and took all concerns and incidents seriously. They discussed matters openly, investigated them thoroughly, and took action to help prevent recurrence. However, communication around these issues did not always include non-clinical staff.

Staff recognised issues and reported them promptly, and managers investigated incidents as they occurred. Staff kept people safe and provided appropriate support.

Staff used appropriate systems to monitor people’s health and review medicines that required regular monitoring. They generally handled medicines well, with a few exceptions, which we highlighted during the assessment. The provider addressed all concerns we identified immediately.

Staff followed a clear process for managing safety alerts, and we saw this working effectively in practice.

They also followed procedures to help protect people at risk of abuse and ensured that staff had the proper checks and training to remain suitable for their roles.

Most staff spoke positively about the leadership and the overall safety culture of the service, which had been improving since the recent merger with another practice. Staff maintained the premises safely, following robust health and safety processes.

However, we identified areas needing attention, including learning from incidents and complaints and how this was communicated throughout the practice. There were also inconsistencies in the retention of documentation within recruitment records. The provider responded with an action plan for future improvements, including the issues we raised during the assessment.

This service scored 66 (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 demonstrated and provided clear evidence of a positive safety culture, built on openness and honesty. Staff had established processes in place to report incidents, near misses, and safety events. Leaders listened to safety concerns, investigated incidents, and reported safety events appropriately. Staff described an open culture where they felt safety remained a clear priority. However, we identified incidents that had taken place that were not documented, discussed or reviewed as a practice team to ensure consistent learning across the board in the event of a repeat occurrence. In addition, although we saw that complaints were dealt with appropriately, actions and outcomes were not consistently documented, discussed and reviewed and again not always shared to ensure learning across all staff. We saw that verbal complaints were also reported and responded to appropriately, but staff responsible for monitoring these did not consistently record actions and outcomes, in order to identify themes and trends.

In response to our findings the provider reviewed ways to improve how the service captured and embedded learning from incidents and complaints across the organisation.

The provider worked collaboratively with people using the service and with healthcare partners to establish and maintain safe systems of care. They implemented effective systems and processes to share information with staff and other agencies, enabling safe care and treatment.

Staff coordinated with other providers to deliver shared care when patients moved between services.

People using the service reported feeling involved in decisions about their treatment pathways and highlighted prompt follow-up care.

Staff understood local services and support networks and referred patients appropriately to meet their needs and help prevent ill health.

Trained care navigators directed patients to the most suitable services based on their presenting needs.

Staff held regular multi-disciplinary meetings to review and plan care for patients with complex conditions or those nearing the end of life.

Clinicians followed established care and treatment pathways and referred people promptly to other services when needed. They made timely referrals to secondary or specialist care, including urgent referrals under the two-week wait rule for suspected cancer, and followed these up appropriately.

Staff processed correspondence from secondary care, such as discharge letters and summaries, quickly and efficiently.

People could request a chaperone for intimate examinations, and staff displayed information about this in both the waiting area and clinical rooms.

The service took active steps to safeguard people from the risk of abuse, working closely with partner agencies when necessary. The provider maintained systems and processes to respond appropriately when staff suspected someone might be at risk of abuse or neglect. Staff we spoke with demonstrated an understanding of when and how to report safeguarding concerns. However, we identified that not all staff had undertaken safeguarding training appropriate to their roles and responsibilities. The provider took action to resolve this.

Staff demonstrated a clear understanding of safeguarding and knew who the designated safeguarding lead was. They explained the actions they would take if they had concerns about a patient’s safety and said they felt confident to report such concerns. Staff added alerts to the patient record system when a person was subject to a safeguarding concern, allowing the wider team to identify and respond appropriately.

Staff knew the people who used the service well. Feedback from patients did not raise any concerns about safeguarding. The provider followed recruitment procedures to ensure staff were suitable to work in the service, although documentation was not always consistent. The provider responded immediately and took steps to correct this.

Staff worked with people to understand and manage risks by thinking holistically. Initial assessments included recording people’s physical, psychological and personal circumstances and people had care plans in place. Shared decision-making was encouraged and facilitated through care plans and communication tools. Patients were supported to participate in their care decisions, with a particular focus on personalised care and risk management. Information was also available online to help people understand their long term conditions and how to manage them. The care and treatment provided was safe, supportive and encouraged people to remain healthy and do the things that mattered to them. People were advised on risks related to their condition and actions to take if their condition deteriorated. Staff feedback around risk management was valued and used to inform ongoing service development.

The service operated from two buildings across a five-mile area in Birkenhead, one significantly larger than the other. The larger site had undergone several enhancements and continued to be developed. The provider actively detected and managed potential risks in both environments with lead responsible staff to ensure this was maintained. Leaders ensured equipment, facilities, and technology supported safe care delivery. They undertook regular checks on the premises, facilities, and equipment, with cleaning and maintenance contracts in place. Health and safety procedures, including fire safety, was established and regularly reviewed. Staff were provided with training in key areas such as fire safety. There was a business continuity plan in place to provide guidance in the event of major disruption to the service, such as an IT failure or flood.

The provider ensured enough qualified, skilled, and experienced staff were in place, offering effective support, supervision, and development opportunities. The provider trained a high number of Foundation (FT) and Speciality (ST) doctors who are trainees at various stages of their internship. They each had a supervisor with dedicated time for supervision and support and also received peer support during daily huddles. Staff reported having regular protected learning time (PLT) meetings, and we reviewed minutes showing discussions on access, appointments, staff education, and communication. Most staff had completed role-appropriate training, and those who had not were given protected time to catch up. Staff across roles said they could deliver safe, high-quality care, provided everyone was present. Teams worked well together, though some staff described an “us and them” culture with reference to some members of the leadership or other individual teams. Prior to our assessment, the leadership team recognised this and had introduced tools to address it.

We reviewed a sample of recruitment records and found that staff were recruited safely with the practice following requirements, but documentation obtained and retained for each member of staff was inconsistent because of the merger. The practice was addressing this and, during the assessment, discussed implementing a standard recruitment checklist to ensure consistency.

Both premises remained clean and well-equipped to support effective infection prevention and control, though the larger building required some decorative improvements. Facilities were designed to enable thorough cleaning and minimise infection risk. Personal protective equipment was well-stocked and appropriately located throughout both sites. The provider actively assessed and managed infection risks, with clear roles and responsibilities, including a dedicated infection control lead. Most staff had completed training relevant to their roles. Regular infection prevention and cleaning audits were carried out, with cleaning schedules in place and equipment was stored securely in line with best practice. Waste, sharps, and clinical specimen management processes kept people safe. The service reported infection-related concerns to relevant agencies when needed. Staff immunisation status was largely up to date in line with UK Health Security Agency (UKHSA) guidance, and the provider had a plan to update and maintain records for outstanding staff going forward.

The provider made sure that medicines and treatments were safe and met people’s needs. We reviewed clinical records for patients who had been prescribed medicines which required routine monitoring. Our review showed that the provider managed medicines safely and their approach to medicines reflected current and relevant best practice and professional guidance.

Our review of records showed that people taking medicines with specific risks that required monitoring were appropriately monitored before their medicines were prescribed. Regular medicines reviews were carried out for people who used the service to ensure their medicines were safe and appropriate to their needs.

Staff had access to emergency medicines and equipment including oxygen and a defibrillator. Emergency medicines were regularly checked for stock availability and to ensure they were in date. Vaccines were stored appropriately, and regular checks were carried out to ensure safe storage and stock.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Appropriate action had been taken in response to the medicines alerts we looked at. The provider had appropriate authorisations in place for Patient Group Directions (PGDs) and Patient Specific Directions (PSDs) (written instructions to supply or administer medicines to patients in planned circumstances for example, vaccinations). There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.