Medwyn 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 patients were protected from abuse and avoidable harm.

The practice had a proactive and systematic approach to safety. Staff, patients, and partners were all actively encouraged to voice their concerns. All team members we spoke with reported feeling part of a collaborative team that worked together to find solutions.

Staff were actively encouraged to attend various meetings. These included discussing complaints, compliments, and significant events, to ensure a culture of continuous learning and improvement. Leaders maintained a culture of openness and collaboration, where safety was the top priority for everyone.

The team demonstrated a strong commitment to improving safety. There were clear roles and responsibilities to achieve safety goals, and risks were consistently assessed and managed. The practice used internal and external learning events, along with robust significant event and complaints analyses, to review and prevent negative outcomes.

At our last inspection, we rated this key question as good. At this inspection, 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 strong proactive and positive culture of safety, based on openness and complete honesty. They actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

Staff members we spoke with said they were encouraged to take on new or additional responsibilities. For example, the Operations Manager, now leading digital transformation started as a receptionist, and the Administration Manager had completed leadership training.

Patients 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 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 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 patients moved between different services

There were systems in place for processing information relating to new patients. The practice worked with other providers to deliver shared care and when patients moved between services. Referrals and test results were managed in a timely way.

Patients were invited to attend a review for all their long-term conditions during their birth month. This was to streamline care, reduce unnecessary visits and ensure patients received information about best practice of their chronic disease management with the most appropriate clinicians.

The practice worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Patients felt supported and that clinicians acted in their best interest to keep them safe.The practice shared concerns quickly and appropriately.

Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. Safeguarding registers for children and adults were reviewed and discussed during quarterly multi-disciplinary team (MDT) meetings, where any trends were monitored. Patient records contained pop-up alerts and alerts were also visible in the Summary Care Record.

The practice worked with patients to understand and manage risks by thinking holistically. They provided care to meet patients’ needs that was safe, supportive and enabled patients to do the things that mattered to them.

National GP patient survey data showed that 97% of patients stated that during their last appointment, the healthcare professional was very good or fairly good at listening to them (national average 87%) and 98% of patients stated they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment (national average 91%).

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 practice 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.

We saw that the practice had effective systems to monitor and comply with risk assessments, including fire safety and legionella testing to ensure that patients and staff remained safe. Records showed fire alarms were routinely tested, and the practice had appointed fire marshals to direct patients and staff in the event of a fire. Staff completed fire training and attended regular fire drills. Electrical equipment had been calibrated and tested. We observed that the practice was accessible for all patients and included space for wheelchairs and prams.

The practice 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 patients’ 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.

Feedback from patients was very positive, particularly regarding satisfaction with staff and ease of access to clinicians.

The practice 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 (IPC) lead and all staff had had relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

The practice used digital technology to improve their IPC standards. Each clinical staff member was responsible for carrying out IPC checks in their clinical rooms at the end of every session and this was recorded using a QR (Quick Response) code. Responses were monitored to check these had been completed, or if anything needed addressing.

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

Staff involved patients in reviews of their medicines and helped them understand how to manage their medicines safely. Patients 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 followed protocols to ensure they prescribed all medicines safely, and ensured patients received all recommended medicines reviews and monitoring.

Medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines. 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 patients prescribed medicines with specific risks received recommended monitoring.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.