Sunniside Surgery Also known as Sunniside 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 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. 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. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from issues.

Staff told us of an open and honest working environment, where leadership provided guidance and encouraged open communication. They felt confident raising concerns, knowing their feedback was valued and acted upon, with safety remaining a key priority. The records we looked at showed teams were reviewing and learning from incidents.

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 clear systems in place for processing information relating to new patients and summarising their records. The service worked with other providers to deliver shared care and when patients moved between services for example adult’s referrals to secondary care or community services.

Referrals and test results were managed in a timely way. We saw all test results were reviewed by the GPs.

The practice ensured effective management and oversight of triage by having 2 doctors in surgery each day with a number of on the day appointments available for staff to use for urgent patient issues throughout surgery opening hours.

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. Staff were able to tell us who the safeguarding leads and deputies were in the practice and how to raise concerns. They told us they received training in both safeguarding adults and children and had a clear understanding of their safeguarding responsibilities for reporting concerns.

The practice had a chaperone policy in place, ensuring that chaperones were available to provide comfort and to help mitigate risk for both patients and staff. We saw staff who required a Disclosure and Barring Service (DBS) check had one recorded, including those acting as a chaperone.

The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations.

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.

We saw examples of minuted multidisciplinary team (MDT) meetings involving health care professionals where patients needs were discussed to help manage risks associated with them.

Patients were advised on risks related to their condition and actions to take if their condition deteriorated. Staff met with patients, their families and carers to discuss their care and treatment. Staff would use alternative methods of communication where needed and had access to interpreters and signers.

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 well maintained. Staff told us they had a regular team who they called upon to address any environmental issues or carry out necessary repairs.

Appropriate emergency equipment and medicines were available and accessible to staff. Clinic rooms were all on the ground floor and were fitted with appropriate flooring and equipment. Appropriate emergency equipment and medicines were neatly stored and easily accessible to staff. However, there was no written risk assessment as to what medicines were required to be available on site in the event of a medical emergency. In speaking with staff, there was a clear rationale around the medication held which had been previously discussed. This risk assessment was in place by the end of the assessment day.

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 well together 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, and staff were working within their agreed areas of competence. Staff reported that they received regular appraisals in which their training and development needs were routinely discussed. They also described an open-door culture within the practice, enabling them to raise learning needs at any time. Examples of recent additional training for staff included Phlebotomy, Nursing Associate, wellbeing, digital training and medical terminology.

Safe recruitment practices were followed. We sampled recruitment files for staff and saw that checks had been undertaken prior to employment. For example, proof of identification, references, qualifications and registration with the appropriate professional body. Staff had a contract of employment and relevant vaccinations were in place.

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 who was the practice nurse and all staff had had relevant training. Cleaning schedules were in place and followed.

Risk assessments and audits were completed, including hand hygiene and actions taken to mitigate risks.

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 helped people 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.

We carried out clinical searches as part of the assessment and found that the practice had effective systems to identify and manage potential risks related to medicines. A small number of issues were identified.

Firstly, there had been 89 medication reviews completed in the last 3 months. Of the 5 records we looked at 2 did not document any patient review information to accurately record the information considered. As a result, it may be difficult for another clinician to determine whether a full medication review had taken place or patients medicines were still meeting their clinical needs.

Our clinical search also highlighted 141 patients who had been prescribed non‑steroidal anti‑inflammatory medicines (NSAIDs) or antiplatelet medicines with 8 of these not being prescribed a medicine to help protect the stomach. We looked at a sample of 5 of the 8 patient records and found that only 1 patient had no record of a discussion regarding the stomach protection medication since 2023. The practice has already taken steps to address this.

During the site visit we reviewed a sample of authorisations for staff to administer medicines under Patient Group Directions (PGD) and noted that some authorising signatures were dated before the second member of staff was added to the document, meaning the authorisation was not valid. This issue was resolved straight away.

However, staff generally followed protocols to ensure they prescribed medicines safely, and ensured people received recommended medicines reviews and monitoring. Staff received regular training, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely.

Medicines were stored securely and at appropriate temperatures. There were no controlled drugs at the practice. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, and vaccines. 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 manage and respond to safety alerts and medicine recalls. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued by the provider was similar to local and national averages.

There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.