Veor 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 Requires Improvement. At this assessment, the rating has changed. This key question has been rated as Good.
 

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 within the service.
Staff felt there was an open culture and learning from incidents and complaints resulted in changes that improved care for others. We saw an example of where a prescription error had been identified, and the actions taken across the service were clear to reduce the risk of such incidents being repeated.
The service also took steps to identify improvements from feedback. For example, implementing a call back function so people did not need to wait in the call queue.
There was a process to record and investigate complaints and learning was shared across the organisation. There were processes for significant events and incident reporting that staff were clear about. Monitoring and analysis takes place to ensure trends are identified. Findings from significant events were discussed in meetings and learning was shared to improve care.
The service undertook staff surveys and leaders and management responded to this feedback. For example, the service highlighted staff feedback in a ‘You said, We did’ style campaign where feedback and the service’s actions taken as a result were clear. For example, staff commented that “Safeguarding training would be better in person, not just online” and the service had responded to this by scheduling face to face training on a half day closure where staff would have protected learning time (PLT).
Staff understood how to raise concerns and report incidents. The service had processes and policies for incident reporting including near misses and safety events and were now monitoring these for trends.
 

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 for processing information relating to new patients and referrals were managed in a timely way. There was a system and process for monitoring and managing Urgent Suspected Cancer referrals (USC), which all staff knew and understood. (USC referrals are for a hospital specialist to see a person with symptoms that may indicate cancer, ensuring they are seen within 28 days).
There were systems for processing discharge information and summarisation of incoming documents to the service. We reviewed the number of outstanding documents that required scanning and found the oldest to be dated 6weeks prior to our onsite visit. Leaders of the service were looking into additional technology to be able to improve this timescale.
We reviewed incoming blood test results and found there were 137 administrative related tasks outstanding. Following our site visit, the service sent us evidence to show these had been completed within 3 days of the assessment taking place and each result had been reviewed for urgency at the time of receiving, to negate any risks.
The service understood the importance of continuity of care and treatment, especially when people moved between services. A daily meeting that included all staff supported continuity of care served as a way to communicate about the day to day running of the service, patient care and staff wellbeing The service also promoted continuity of care and treatment for certain groups of people who used the service, such as people living in care homes by having a designated clinician to carry out home rounds and visits.

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.
The service had systems to protect vulnerable people from abuse. The safeguarding lead was supported by a GP for clinical oversight, and there was evidence to show how this worked in practice. There was a safeguarding handbook that included processes and highlighted information around homelessness and people who did not attend appointments.
The service worked with other teams to protect people from harm and gave examples of where the service has attended multiprofessional safeguarding meetings. We received feedback in relation the service’s approach to safeguarding. A partner from the Local Authority working with the service fed back to them that ‘’ Veor Surgery has demonstrated commendable engagement with the process. They have been exceptionally proactive in ensuring that appointments for service users are promptly offered or arranged in coordination with the allocated social worker / family worker when needed. This level of responsiveness and cooperation has greatly facilitated the safeguarding process, ensuring that the needs of vulnerable individuals are met in a timely manner.’’
Where there was a safeguarding concern about a person, the service was able to highlight this on the person’s records and link it other family members. An example was given about how this supported the identification of a minor who may be at risk of harm.
Staff had received training in safeguarding adults and children relevant to their role, and they were able to access policies and procedures which contained up to date information and guidance. They were aware of who the safeguarding leads were for the service and how to raise concerns.
 

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.
The service had guidance for medical emergencies and staff were aware of this. Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and knew of action to take. People were advised on risks related to their condition, including their medicines and what actions to take if their condition deteriorated.
Receptionists received training on emergency symptoms, such as sepsis, and clinical staff were available to support the receptionists with clinical advice where required.
We saw examples of how the service triaged patient concerns with the duty GP working alongside reception staff. We saw people being advised on risks related to their condition and actions to take if their condition deteriorated. This could be provided in different ways to meet people’s individual needs, such a text messages or in easy-read formats.
 

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 was well-maintained and free from clutter during our onsite visit. People could access the building and consultation rooms easily, with space for mobility equipment. The service had considered risks associated with the environment and completed risk assessments. For example, a wheelchair risk assessment which enabled wheelchairs to move around the environment safely. There were spaces available for confidential conversations, which were signposted to people using the service. There were processes to support staff if people using the service became aggressive.
A health and safety risk assessment for the service’s premises had been completed in June 2025, and identified actions had been completed within recommended timescales. The service had a process for ensuring security of the building and had an appropriate risk assessment to support this.
Clinicians had access to the equipment they needed. Equipment was calibrated within recommended timescales and was in good working order.
Eemergency equipment and oxygen were now included as part of the service’s health and safety checks. We observed oxygen cylinders to be full and included appropriate signage.
During our onsite visit, we reviewed a random sample of electrical items and found that electrical plugs were in need of portable appliance testing (PAT). Following the onsite visit, the service confirmed this had been arranged to take place within 8 weeks.
There were policies, procedures and risk assessments relating to fire safety at the service. Staff took part in regular fire drills. Clear signage throughout the building supported staff and people who used the service during an emergency evacuation, as well as a Personal Emergency Evacuation Plan (PEEP).
 

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 was a training handbook that outlined the training staff needed to complete and the service were able to monitor this. Where training had expired the service had an ongoing plan to address this is, as well as appropriate systems to monitor completion.
We reviewed 3 recruitment files and found the service had followed their policy in relation to seeking references and Disclosure and Barring Service (DBS) checks. (Disclosure and Barring Service (DBS) is a check which enables employers to check the criminal records of current and potential employees to ascertain whether they are suitable to work). Staff had received an induction and for clinical staff, professional registrations were recorded and valid. Records of staff immunisations were available in the staff files reviewed with, with the exception of one member of staff, which the service was actively working towards improving.
The service has a clinical supervision policy. However, we received mixed feedback from staff in relation to clinical supervision. Some staff fed back they did not always get regular supervisions with leaders. Following our onsite visit, the service confirmed they had addressed this by reviewing how clinical supervision was recorded and how it is monitored that it is taking place. However, this required time to be implemented and embedded to ensure it was effective.
Staff told us they knew when to ask for GP support, if it was out of the scope of their clinical competency or if they required additional clinical oversight. Staff members were able to access external clinical supervision through a local training hub.
There was a policy for appraisals and systems to monitor appraisals were taking place. However, we observed in the staff files reviewed that one staff member had not had an annual appraisal since being employed by the service for over a year and another staff member told us they had not had an annual appraisal in the last few years.
There were a range of clinical and non-clinical roles within the service. Training was up to date, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence. Leaders supported staff with career progression. For example, health care assistants were undertaking training to become Nursing Associates. External learning and development opportunities for staff were supported by leaders and staff could access ongoing training relevant to their role.
 

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 a designated infection, prevention and control (IPC) lead and staff had had relevant training.
The service had policies to support IPC and a programme of audits to ensure compliance. Where there were outstanding actions there was a plan with timescales to address these.
The IPC lead had undertaken a review of the premises, procedures and arrangements for environmental cleanliness audits to ensure effective IPC. An annual statement had also been completed.
Sharps management processes were followed with sharps bins used appropriately. Cleaning was carried out by an external contractor, and the quality of the cleaning was audited by the contractor, and they had a cleaning schedule to follow. However, the service was not monitoring the cleaning provided by the external contractor. Following the inspection, the service had implemented additional audits to monitor the quality of the cleaning contractor. Cleaning equipment was stored safely. The premises of the service was noted to be visually clean during our onsite visit.
Staff knew the process for handling specimens and what to do in the event of a spillage.
Personal protective equipment (PPE) was available to staff, and the service held stocks of PPE. There were handwashing facilities throughout the service, with handwashing posters displayed. However, we observed where water was a not always regulated to a safe temperature, there was no warning to advise people of this. We raised this with the service at the time of our onsite visit and the service acted quickly and implemented warning signs.
 

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.
The service had emergency medicines accessible to staff. However, we found there was not an assessment of which emergency medicines were required. The service took action immediately to remedy this and provided an assessment of which medicines were required.
Staff involved people in reviews of their medicines. People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. However, our clinical searches found that people had not been informed about the risks of their prescribed medicines following a safety alert. The service took action and arranged reviews for people affected.
Staff received regular training and felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely in line with national guidance. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs.
Clinicians followed protocols to ensure they prescribed all medicines safely, including where they were concerned about unusual prescribing.
Waste medicines were recorded and disposed of appropriately including medicines returned by people who used the service. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments.
The provider had systems to manage and respond to safety alerts and medicine recalls, and these were discussed at daily meetings.
Clinicians took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Audits to monitor the prescribing practises of non-medical prescribers had been introduced since our last inspection.
There was an auditing process to ensure people received recommended medicines reviews and monitoring in line with national guidance and processes to follow up people that did not attend their monitoring appointments. This was carried out by the service on a monthly basis and, where there were people identified as requiring monitoring, action was taken.
However, these systems were not always effective in ensuring people had been monitored within the correct timescales. For example, as part of our assessment, we conducted a series of remote clinical searches and records review, and we identified people who were prescribed certain medicines did not always receive the required monitoring . For example, people who were prescribed amiodarone, a medicine that helps control heart rhythm, had not received the correct monitoring in 4 of the 7 clinical records we reviewed. Where people were being prescribed methotrexate (a medicine used to treat autoimmune conditions), records did not have a day of the week documented to take their medicine as required by national guidance.
Following our onsite visit, the service sent us evidence of people within these affected groups having attended appointments or had appointments arranged for the required monitoring to be undertaken.
We reviewed patient group directives (PGDs) and found these had been signed after they were authorised. This meant that staff were not appropriately authorised to administer these medicines safely. The service took action to remedy this following our onsite visit and confirmed completion in an action plan.