Saltdean and Rottingdean Medical 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.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed.

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. 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. The service was in the process of reforming its own Patient Participation Group (PPG). However, to understand people’s current views of the service, leaders met with representatives from the Primary Care Network (PCN) PPG. They said the provider listened to concerns and 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 people 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 patients 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. Weekly meetings were held to discuss safeguarding and covered recent referrals and actions to be taken. The service also held specific safeguarding learning events to share relevant information with staff and provide time for training to be completed.

The service actively followed up safeguarding cases with the local authority team so they were aware of relevant outcomes and actions and could update their records and the clinical team.

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 the actions to take. Staff had all undertaken sepsis training. 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.

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 service carried out legionella testing and portable appliance testing to ensure staff and people were safe and revised them annually or more frequently in response to change.

Maintenance contracts were in place to maintain the accuracy of equipment, such as regular calibration. Scheduled safety checks were conducted on the fire alarm system, emergency lighting and equipment.

There was a business continuity plan in place which was monitored and reviewed.

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. Staff had undergone Disclosure and Barring Service (DBS) checks (DBS is a way for employers to assess the suitability of individuals for certain roles) or if a DBS had not been completed appropriate risk assessments were in place.

There were multidisciplinary teams within the service, with a range of clinical and non-clinical roles. Training was up to date, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence. New staff undertook a period of induction with a comprehensive checklist. Once completed the documents were held in the staff files.

Managers carried out regular meetings with staff and annual appraisals were in place and documented in staff files.

The service had improved its recruitment processes to be in line with national legislation. We reviewed 5 staff recruitment files during our onsite visit. All 5 contained the required documentation.

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 (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. For example, carpeted areas had been removed and replaced with appropriate floor covering. Sharps bins and clinical waste were stored in line with legislation.

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.

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 in 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, and ensured people received all recommended medicines reviews and monitoring. 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. Expired medicines were recorded and disposed of appropriately including medicines returned by patients. The service stored medical gases, such as oxygen, safely and completed required safety risk assessments.

The service 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.

Prescribing data reviewed as part of our assessment showed the service was prescribing antimicrobials in line with national averages. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.

Since the last assessment the service recruited a pharmacist to work with the prescribing GP to review the relevant policies and procedures and make improvements where necessary. These were shared with the rest of the prescribing team to ensure patients’ medicines are being regularly reviewed.