Dr Rozewicz & Partners Also known as Simpson House Medical Centre

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 in July 2016, 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. 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. The service 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 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 people 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. 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 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. Staff could recognise a deteriorating patient 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. There was a business continuity plan in place which was monitored and reviewed.

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. The premises were undergoing refurbishment, and we observed areas that had already been completed, such as the staff kitchenette. We were told the remaining work included improvements to fixtures and fittings within some clinical rooms.

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. Safe recruitment practices were followed.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and were aware of how to share concerns with appropriate agencies promptly.

The service had a designated infection prevention and control (IPC) lead, and all staff had received relevant IPC training. Cleaning schedules were in place and were being followed. Risk assessments and audits had been completed, and actions were taken to mitigate identified risks. However, the most recent IPC audit did not identify that some hand wash basins in clinical rooms were not fully compliant with IPC guidelines. The provider informed us that these sinks were scheduled for replacement as part of an ongoing refurbishment programme, which included upgrades to the plumbing and heating systems. Following the inspection, the provider submitted evidence of progress with the refurbishment work. This included replumbing of waste systems in a treatment room and installation of tiled splashbacks in a consulting room to reduce IPC 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. However, we identified some variability in relation to medicines requiring monitoring, with some patients overdue blood test monitoring.

Medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Waste medicines were recorded and disposed of appropriately including medicines returned by people. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments.

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 and felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely.

Data reviewed as part of our assessment showed that the service was performing better than or in line with national averages for prescribing indicators we reviewed. These prescribing indicators related specifically to medicines often used for nerve pain, mood or mental health, insomnia and bacterial infections. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.

The majority of our clinical searches demonstrated that staff followed established protocols to ensure medicines were prescribed safely, and that patients received the required medication reviews and appropriate monitoring. However, we identified a few people prescribed medicines that primarily treated high blood pressure who were overdue blood test monitoring. The provider immediately reviewed these people and identified that 1 patient had been abroad for over a year, and 2 patients had subsequently been booked in for monitoring. The practice maintained call and recall processes for patients on complex medications, polypharmacy and those prescribed high-risk medicines. Leaders responded promptly and proactively by arranging a dedicated meeting to review the assessment findings, identify any gaps in existing processes, and implement improvements to patient care. An additional emergency meeting was held with the pharmacy team to review prescribing policies and to actively identify, contact, and invite any further patients who required monitoring.