Southlands Medical Group

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 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice 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. Representatives from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical issues. Staff felt there was an open culture, and that safety was a top priority.

There were standing governance and safeguarding items discussed at clinical team meetings which included significant events, complaints, new patients and mortality reviews. Actions from this meeting were actively tracked.

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.

The practice supplied records of significant events and a summary of complaints received over the previous 12 months. Review of this information identified any recurring themes to which the practice had recognised and responded to. This demonstrated that the practice was using incidents and feedback as opportunities for learning and quality improvement.

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

The practice could clearly explain their safeguarding process. They had an administrative safeguarding lead who had a defined job description of their role regarding safeguarding, such as audits and follow up actions.

The practice 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. 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 practice 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.

The service made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs. Safe recruitment practices were followed.

Leaders develop coordinated and adaptive anticipatory strategies to manage demand and capacity issues relating to staffing and have systems and processes that support this. For example, the practice reviewed staffing mix to ensure they could provide better access for patients in using advanced nurse practitioners (ANPs) and duty GPs to manage triage and to allow wider GPs to manage the routine appointments.

There was a continual development of staff skills. Competence and knowledge were recognised as integral to ensuring high-quality safe care, improved access and service sustainability. Staff were proactively supported to acquire new skills and share best practice. All staff had shared and personal objectives, and regular appraisals. Audits were carried out to ensure they were working within their competence.

Training was up to date with additional training tailored to the job role and person, for example care navigation and appointment booking.

Staff told us that there was a culture where they were encouraged to develop. For example, a member of administration staff had been encouraged to train as a phlebotomist.

The practice invested in targeted development of staff to ensure successors were identified for leadership roles. The GP partners were developed and there were GP trainers to increase educational capacity. There had been recruitment of doctors with special interests, for example diabetes, woman’s health and paediatrics.

Training and development improved staff confidence in working independently in community settings, including home visits and urgent care. This increased prescribing capacity.

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. They had comprehensive systems in place to manage ensure the practice was meeting the correct standards. All staff had received relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

The service mostly 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.

We carried out remote searches of clinical records as part of our assessment to check how the practice monitored patients’ health in relation to the use of high-risk medicines. We looked at 5 patients in detail, out of 270, who were prescribed an antiplatelet medicine used to prevent dangerous blood clots, heart attacks, and strokes. In 4 patients we had some concerns. These patients should have been prescribed a proton pump inhibitor (PPI) medication to lower the risk of upper gastrointestinal bleeding. The practice immediately reacted to follow this up and sent us an email to reassure us that this had been actioned.

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 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. Staff followed protocols to ensure they prescribed all medicines safely. They worked to a defined review programme.

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, and controlled drugs. Waste medicines were recorded and disposed of appropriately including medicines returned by patients. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments.

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.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued by the provider was lower than local and national averages. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.