The Green Surgery Also known as The Green & Fir Road Surgeries

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 75 (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. All staff including non-clinical were made aware of significant events. Fortnightly clinical meetings and monthly team meetings took place to discuss these matters, and the agenda and minutes were circulated to ensure all staff were kept informed, including those who were unable to attend.

They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Staff gave an example of a significant event which had occurred recently. The incident related to an urgent situation being managed through routine appointment processes. The event was documented comprehensively and dealt with efficiently. This had led to improvements in the service. Other significant events had been recorded in the same way.

People told us that they felt supported to raise concerns and felt staff treated them with compassion and understanding. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical issues. Staff told us there was an open culture, and that safety was a top priority. The provider had processes for staff to report incidents, near misses and safety events, which included, for example, a significant events policy and significant events log. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. We reviewed the complaints log and found it was managed in line with requirements. For example, a complaint relating to staff communication had been reviewed appropriately, and actions were taken to address the issue. Complaints were recorded consistently, with each entry including the date received, a description of the issue, and the actions taken. We also saw that responses were issued within the stated timescales and that outcomes were clearly documented.

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 patients moved between services. Staff reported that referrals and test results were managed in a timely way. For example, that two‑week‑wait referrals were processed within two days to meet clinical safety standards and ensure patients were seen promptly. Clinicians said that they were aware of incoming referral requests and could action or approve them when required, ensuring clinical oversight was consistently maintained.

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. Although the practice did not have a dedicated Female Genital Mutilation (FGM) policy, staff were aware of the required procedures. Clinicians could explain how they identify and record FGM concerns, including those arising from patient history, maternity contacts or multi‑agency alerts. Staff reported that a monthly search of relevant codes was carried out to monitor patients who may be at risk. Safeguarding was a standing item at fortnightly clinical meetings and discussed in wider team meetings when appropriate. Information was shared in a way that maintained confidentiality while ensuring staff had the awareness needed to act safely.

The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations. Information about how to escalate concerns to the local authority were available in staff reception on notice board, stored electronically

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. Equipment and medicines were stored in a central place which was accessible to all staff. Staff we spoke with were aware of what to do in an emergency and demonstrated they knew how to use equipment. 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 service made sure equipment, facilities and technology supported the delivery of safe care. We saw that gas, fire, and electrical maintenance contracts were monitored, and checks were carried out in a timely manner. Contracts were in place to ensure the premises were maintained. They had an up-to-date water testing certificate, and we did not identify any health and safety concerns during our site visit. However, the service did not have some key documentation available, such as a written Health and Safety risk assessment and a Legionella risk assessment, to confirm that risks had been fully assessed. There was a business continuity plan in place which was monitored and reviewed. A fire risk assessment was completed annually, with the most recent one carried out in January 2026.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support and development. There were a range of clinical and non-clinical roles within the practice. We found the development of staff was managed appropriately, and staff were working within their agreed areas of competence. Staff feedback indicated that they were encouraged to develop and had opportunities to complete internal and external training. They worked together well to provide safe care that met people’s individual needs.

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. During the site visit, there was no clinical cleaning schedule, we were told this was being developed and staff would sign and date once implemented. There was a cupboard for all cleaning materials which was clean, tidy, and well organised. All rooms had sufficient supplies of liquid soap and paper hand towels. Risk assessments and audits were completed. We reviewed the Infection Control Audit, which is carried out annually, with the most recent completed in April 2025. Some actions to mitigate identified risks had been implemented, while others remained in progress.

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. Our review of records showed regular medicine reviews were carried out for people who used the service to ensure their medicines were safe and appropriate for their needs.

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. They told us that they felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely. Blank prescriptions were stored in a safe location and were locked away.

Medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines. We saw logs of checks to fridge temperatures that stored medicines and checks staff carried out to monitor expiry dates of medicines.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff told us the pharmacy technician reviewed and raised relevant alerts with the GPs, and that messages were circulated to staff and issued to patients and prescribers of any affected medicines