The Ross Practice

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.

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff had regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes.

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. Lessons were learnt to continually identify and embed good practice.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. During staff meetings, the team discussed and learnt from clinical issues. Staff felt there was an open culture. 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. Learning from incidents and complaints resulted in changes that improved care for others.There were regular case reviews of clinical staff consultations and audits were conducted periodically of prescribing to identify improvements.

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 people who had recently registered with the service The service worked with other providers to deliver shared care and when people moved between services. Referrals and test results were managed in a timely way. The provider had a system in place to follow up on referrals that had been delayed.
 

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. The service 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 and was shared with another provider in the same building, the service confirmed plans to risk assess the sharing of this.
During the site visit the service did not hold all the recommended emergency medications, the service confirmed on the day of the visit they would review this and assess appropriately with risk assessments where required.
Staff could recognise a person whose health may be deteriorating and knew of action to take. People 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. At the time of assessment, the lift was not working however we had seen evidence of ongoing discussions to rectify this with the building owners. 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 and outlined how the service would continue to operate in the event of a disruption.

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. Learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence.

At the time of the site visit, we reviewed a small sample of training records for staff at the service. Some of the staff records viewed on the day were not up to date with training. Some training records were sent to us shortly after the site visit. The provider confirmed they were in the process of addressing this.

At the time of assessment not all staff records we sampled had evidence of vaccinations, the provider confirmed they were in the process of addressing this. No risk assessments were available at the time of assessment for either of these.

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

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

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 followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring.

Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Staff stored medical gases, such as oxygen safely.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring.

There was a programme of regular clinical audits of prescribing that focused on improving care and treatment and staff we spoke to were able to recall information about audits and knew where to find information about them.