Loddon Vale Practice

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.

The service had a positive learning culture and people could raise concerns which leaders investigated thoroughly. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right qualifications and experience. Managers made sure staff received regular appraisals. Staff managed medicines well and involved people in planning any changes. This key question has been rated as good.

This service scored 66 (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.

The practice had a system in place to record and investigate complaints. Feedback and information on how to make a complaint were available in the practice and on their website. We reviewed a random sample of complaints and found the provider had responded in a timely manner and offered to resolve them. Lessons were learnt from complaints and shared with the practice team to improve the quality of care.

The practice held meetings, where staff discussed and learnt from complaints and significant events. Staff felt there was an open culture, and that safety was a priority. We noted there was an effective system to record and investigate complaints, and when things went wrong.

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. Referrals and test results were managed in a timely way.

There were a range of structured meetings in place to plan effective patient treatment. These included clinical meetings, management and meetings about patients receiving palliative care.

The practice followed established care and treatment pathways and referred people promptly to other services when needed. They made timely referrals to secondary or specialist care, including urgent referrals under the two-week wait rule for suspected cancer, and followed these up 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.

There was a safeguarding lead for children and adults, and all staff were aware of who to speak to if they identified a safeguarding concern. There were processes in place to follow up children and young people who were not brought to their appointments with the provider and for secondary care appointments. We saw evidence that safeguarding meetings were held on a regular basis to review people at risk.

However, during the inspection we found that not all clinical staff at the practice had completed safeguarding training to the required level in line with the intercollegiate guidance for safeguarding children and young people. This meant staff were not fully compliant with national training standards as required.

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 care and treatment provided was safe, supportive, and encouraged people to remain healthy and do the things that mattered to them. People were advised on risks related to their condition and actions to take if their condition deteriorated.

All staff were trained in basic life support and were aware of actions to take if they encountered a deteriorating or acutely unwell patient and had been given guidance on identifying such patients.

The service detected and controlled potential risks in the 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.

Evidence provided by the practice showed equipment was regularly calibrated and electrical items were Portable Appliance Testing (PAT) tested. Regular checks were carried out on the premises and facilities. Fire safety policies were in place and staff were aware of how to access these. Systems were in place for the regular checks of fire alarms, extinguishers, and fire evacuation procedures. However, the fire marshals at the practice had not undertaken additional training required for the role.

The premises were clean and well maintained. Clear signage around the building supported people and staff in the event of an emergency evacuation.

The service made sure there were enough qualified, skilled and experienced staff, who worked together well to provide safe care that met people’s individual needs. However, systems in place to support safe staffing were not effective.

There were a range of clinical and non-clinical roles within the practice. We reviewed a sample of personnel files and found appropriate employment checks had been completed however recruitment documentation was incomplete in some staff files.

We found training for staff at practice was not up to date for a number of areas, such as Mental Capacity Act (2005) awareness training, safeguarding training for child and adult and infection prevention and control training.

Following the onsite visit, the provider shared evidence of missing documentation.

Staff immunisation status for some staff was not up to date in line with UK Health Security Agency (UKHSA) guidance. The provider shared they had a plan to update and maintain the missing records going forward.

The service assessed and managed the risk of infection.

The practice had a designated infection, prevention and control leads. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

Regular infection prevention and cleaning audits were carried out, with cleaning schedules in place and equipment was stored securely in line with best practice. Waste, sharps, and clinical specimen management processes kept people safe.

The service made sure it met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

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

We saw staff had the appropriate authorisations to administer medicines under Patient Group Directions (PGD) and Patient Specific Directions (PSD)

Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Medical gases, such as oxygen were stored safely and completed required safety risk assessments. The provider had effective systems to manage and respond to safety alerts and medicine recalls.

As part of the assessment, we carried out remote clinical searches. We reviewed a number of patients’ clinical records; the clinical searches highlighted the practice recall system did not always capture patients who were overdue monitoring. The provider sent assurances that actions had been taken to review the patients highlighted through our searches. However, this action was only taken after our intervention, indicating a lack of effective clinical oversight and systems to proactively identify and address these safety risks.