The Vale Surgery

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 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.

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. People felt supported to raise concerns. Representatives from the Patient Participation Group (PPG) told us that the provider took concerns seriously and proactively made improvements to the service. Managers encouraged staff to raise concerns when things went wrong. During clinical meetings, staff reported that the team discussed and learnt from clinical issues. Staff felt there was an open culture, and that safety was a priority. The provider had processes for staff to report incidents, near misses and safety events, which included, for example, a significant events policy and significant events log. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. We reviewed the complaints log and found it was managed in line with requirements. Complaints were recorded consistently, with each entry including the date received, a description of the issue, and the actions taken. We also saw that responses were issued within the stated timescales and that outcomes were clearly documented.

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. For example, two-week wait referrals were completed using the appropriate template and sent promptly, typically within 24 hours.

The service worked with people and healthcare partners to 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. Staff described clear escalation pathways and were able to explain how concerns were raised with the relevant professionals depending on the situation. Safeguarding outcomes were discussed within the team to support oversight, learning, and continuous improvement. The practice also engaged in multi agency working, including contributing to child in need meetings.

The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations.

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. Equipment and medicines were stored in a central place which was accessible to all staff. Staff we spoke with were aware of what to do in an emergency and demonstrated they knew how to use equipment. 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. We saw that gas, fire, and electrical maintenance contracts were monitored, and checks were carried out in a timely manner.

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. However, these actions were not consistently documented. 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. Staff feedback indicated that they were encouraged to develop and had opportunities to complete internal and external training. They worked together well to provide safe care that met people’s individual needs. However, we identified some gaps in oversight. Recruitment records were not always complete, and there were instances where required training, including fire warden training, had not been completed.

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. During the site visit, we saw there was a cupboard for all cleaning materials which was clean, tidy, and well organised. All rooms had sufficient supplies of liquid soap and paper hand towels. Although the practice was observed to be clean at the time of inspection, there was no formal clinical cleaning schedule or clearly defined rota in place. Discussions with staff indicated that cleaning was carried out regularly, with administrative staff providing oversight at the end of each day. While risk assessments and audits were completed and mitigating actions taken, there was no recorded evidence of this. During feedback, the provider confirmed that they would introduce a clinical cleaning schedule and ensure actions from risk assessments are clearly documented.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. 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, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely. Blank prescriptions were stored in a safe location and were locked away. Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring. Medicines including controlled drugs were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines. We saw records of checks to fridge temperatures that stored medicines and checks staff carried out to monitor expiry dates of medicines.

Waste medicines were recorded and disposed of appropriately including medicines returned by patients. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. The provider had a system to manage and respond to safety alerts and medicine recalls. Staff told us that the pharmacy technician reviewed information, escalated relevant alerts to GPs, and discussed these during clinical meetings. During the site visit, we also observed ongoing audit activity and continuous review processes aimed at identifying and mitigating potential risks. Patients identified through these processes were prioritised for medication reviews, with adjustments made where appropriate. Each patient was allocated a named GP. Requests and care decisions were reviewed in line with the duration of the request and were discussed with the patient, taking into account their individual circumstances.