The Ridgeway 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 69 (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 learnt to continually identify and embed good practice. These were discussed at Practice meetings which were held monthly. Staff we spoke with felt supported to raise concerns and felt staff treated them with compassion and understanding. Representatives from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. This included introducing a blood pressure machine in the waiting room of the practice. The provider had processes for staff to report incidents, near misses and safety events. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support.

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. 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.

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. Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations. However, during our site visit, we found that not all household members for patients on a safeguarding register were coded appropriately. One patient who was on the practice safeguarding register was not yet coded on their system. These points were actioned by the practice after the site visit.

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 well maintained. Staff could recognise a deteriorating patient and knew of action to take.

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.

During our site visit, we found that the utility cupboard would not lock or close properly once open. This was actioned and fixed by the practice after the site visit. At the Alexandra Avenue site, we found 3 oxygen cylinders which were labelled with dates that had expired. There was one other cylinder which was in date. This could have been confusing for staff if oxygen was needed in an emergency. Since the site visit, the practice have actioned this with the oxygen supply company and the tanks with out-of-date labels have been removed.
 

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. 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.

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. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. Staff managed prescription stationery appropriately and securely. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. The practice had medical oxygen and a defibrillator for use in a medical emergency. The only issue we found in this regard is that we found there were 3 oxygen cylinders with out of date stickers at the Alexandra Avenue site, although 1 was in date. This could have caused confusion for staff requiring to use it. The practice resolved this immediately after the on-site visit.

In our clinical search, we found minimal areas for improvement. In our search for Medicines requiring monitoring, 2 out of 7 patients we looked at required a review to ensure that they were up to date with their bloods. In our search for MHRA Safety Updates, we found 2 out of 5 patients requiring blood tests. The practice actioned these immediately after the on-site visit.

Prescribing data we reviewed showed the number of patients prescribed of medications used to treat nerve pain and seizures per 1,000 patients was significantly better than the England average. Our searches showed an observation of 74‰ (per thousand) and the national average was 136‰. The number of patients prescribed psychotropic medicines showed the number was better than the national average. We observed 4‰ and the national average was 7‰.