Stock 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 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 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 practice 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.

There was a clear process for identifying, recording and sharing information regarding significant events. Leaders and staff told us they knew how to identify and report concerns, safety incidents and near misses both internally and externally. They were able to discuss evidence of learning and dissemination of information and we observed these were discussed at significant event meetings. Staff spoken with and those who completed a questionnaire said they felt comfortable raising concerns and that there was both an open culture and an open-door approach.

The practice had a system in place to manage safety alerts. As part of our assessment, clinical record searches of the practice electronic system were undertaken by a CQC GP Specialist Advisor. These searches were visible to the practice. We reviewed a sample of patient records who may have been affected by a Medicines and Healthcare products Regulatory Agency (MHRA) alert and found a small number of patients had not been followed up and informed of any possible adverse effects of the medicine. The practice took immediate action to address this and made changes to ensure their process was more robust.

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 people 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.

The practice had systems to identify review and safeguard patients. The staff team were aware of the safeguarding lead and of the process to take if they had concerns. The practice had a system to highlight vulnerable adults and children. The practice 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.

The practice worked with people to understand and manage risks. They told us they provided care to meet the immediate and on-going needs of their patient population. Positive patient feedback received by CQC supported this.

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 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 or were scheduled to be addressed. There was a business continuity plan in place which was monitored and reviewed.

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 people’s individual needs.

There were a range of clinical and non-clinical roles within the practice. We found training was undertaken, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence. Recruitment practices had some gaps. The practice was aware and had taken action to address these prior to the assessment. For example, prior to the assessment Disclosure and Barring Service (DBS) applications had been completed for those non-clinical staff who did not have one. The practice told us clinical staff had appropriate DBS and this was demonstrated in personnel files reviewed.

Staff told us that any gaps in staffing due to absence or vacancy was managed by employing locum staff or existing staff members taking additional shifts. For example, where a nurse post had been vacant, the practice arranged for a nurse with the required specialism within the PCN to support them when required.

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 was clean and well presented during two site visits. Treatment rooms were well organised. The practice had a designated infection, prevention and control 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 service mostly made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Where shortfalls were identified the practice took immediate action and implemented new processes to ensure a robust approach. They involved people in planning, including when changes happened.

As part of our inspection clinical record searches were undertaken by a CQC GP Specialist Advisor. These searches were visible to the practice. Overall, we found the monitoring of patient’s medicines mostly followed national guidelines.

Searches completed identified small numbers of patients who required monitoring and the practice took immediate action to address these areas and to put additional processes in place where appropriate.

Overall, staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. 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. Staff followed protocols to ensure they prescribed medicines safely, and ensured people received recommended medicines reviews and monitoring. The practice used an NHS Digital assured patient support system to help identify patients who required 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. 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.

There were suitable processes for staff to follow when dispensing medicines (dispensing practices). Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data was reviewed as part of our assessment. The NHS Business Services Authority medicines data in October 2023 to September 2024, which reviews hypnotic, multiple psychotropics and antibacterial prescribing showed 1 out of 6 results were below the national average for the practice.This was in relation to broad-spectrum antibiotics. The practice told us they had taken action to address this.