Hazelwood Group 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 in 2006, 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.

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. 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 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. We found the provider was up to date with summarising patient records. The service worked with other providers to deliver shared care when patients moved between services. During our assessment we reviewed the systems and processes for referrals and test results and found they 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.

We found examples of non-clinical staff recognising safeguarding concerns and a clear process of escalation and support to individuals because of this awareness. The practice clinical system had safeguarding alerts to ensure vulnerable patients were managed appropriately and we found safeguarding meetings to be clear and evidenced actions taken.

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 what action to take. Patients 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. Whilst the building was dated, the practice took necessary actions to keep the premises safe to deliver effective care. 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.

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. During our assessment we reviewed five staff files and found safe recruitment practices were followed and maintained.

The service overall 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 completed relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed. The practice had some outstanding actions identified in the infection prevention and control audit such as installation of elbow taps and wipeable blinds in clinical areas. We saw evidence of escalation to managers for these areas to be addressed.

The service did not always make sure that medicines and treatments were safe and met people’s needs and preferences.

As part of our assessment, remote clinical searches were conducted by a GP Specialist Advisors. During the clinical searches, we found that not all systems and processes worked effectively as not all medication reviews and monitoring were completed in line with best practice. We reviewed a selection of patient clinical records and saw instances whereby staff had prescribed high risk medicines to patients without the required monitoring tests and reviews being undertaken.Following our feedback the provider took immediate action and provided evidence to show these patients were followed up for monitoring, the provider also discussed findings with the clinical team and put systems in place to identify patients needing a review. Although no immediate risk to patients was identified, the provider did not routinely audit safety alerts to ensure new patients were not affected, the provider acknowledged this feedback and implemented systems to safety net new patients in the future.

Staff received regular training, were competency assessed in medicines optimisation, and felt confident managing the storage, administration, and recording of medicines. People knew what to do and who to contact if their condition did not improve or if they experienced any unexpected symptoms. Prescription stationery was managed appropriately and stored securely.

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. Waste medicines were recorded and disposed of appropriately including medicines returned by patients. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments.

The provider had effective systems to monitor and review emergency medicines and equipment, however the medical equipment was accessible to patients, and the emergency medicines were within the dispensary, the provider took immediate action to centralise all emergency equipment in a staff only area to ensure it was readily available at all times.

The provider had effective systems to manage and respond to safety alerts and medicine recalls, however we found these audits were not repeated to ensure new patients were not affected by historic safety alerts. Whilst we found no risk to patients the provider took immediate action and set a new protocol to repeat searches on a monthly basis. There were suitable processes for staff to follow when dispensing medicines. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics.