Handforth Health Centre

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 Inspection, 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 practice had a positive learning culture that focused on identifying risks, learning from concerns and improving patient safety. Complaints, incidents and significant events were reviewed regularly, and learning was shared across clinical and non-clinical teams. Staff told us leaders encouraged openness and supported staff when things went wrong, focusing on learning rather than blame.
We saw evidence of this approach when concerns were identified with patient recall processes. The practice reviewed 6 months of records, identified patients requiring follow up and implemented changes to strengthen oversight and reduce future risks. Staff received additional support and training, and the practice used two-cycle audits to monitor whether improvements had been sustained.
Leaders used learning to strengthen systems and improve care. For example, reviews of incidents led to additional checks for histology results and improved monitoring of referrals. Patient feedback was also used to make improvements, including changes to increase confidence in hand hygiene practices. This demonstrated a culture where concerns were used to improve services and reduce the risk of harm.
 

The practice had effective arrangements to support safe care and treatment. Patients accessing the service were assessed through a triage system that helped ensure people were directed to the most appropriate clinician or service based on their needs. Staff described clear escalation processes, clinical oversight and the benefits of operating the triage system during extended hours to meet the needs of people using the service
Systems were in place to manage referrals, results, discharge information and clinical correspondence safely. The practice had strengthened workflow management processes and used electronic tracking systems to ensure actions remained open until completed. We saw evidence that urgent referrals were actively monitored and followed up where necessary, reducing the risk of delays in treatment.
The practice worked collaboratively with other services to support people whose needs required ongoing or coordinated care. Dedicated GP support for care homes, regular reviews of vulnerable patients and multidisciplinary discussions helped ensure information was shared appropriately and patients received continuity during transitions between services.
 

The practice had effective safeguarding arrangements and a clear commitment to protecting people from abuse and avoidable harm. Staff received safeguarding training appropriate to their role and understood how to recognise concerns and escalate them promptly. Leadership responsibilities were clearly defined, and safeguarding was routinely discussed through established governance arrangements.
Staff identified safeguarding concerns through a range of routes, including patient registration, clinical consultations and information received from partner agencies. Information was recorded appropriately and safeguarding registers supported oversight of people at risk. Administrative and reception staff also understood their role in safeguarding and were able to describe the action they would take if concerns arose.
The practice worked closely with health visitors, school nurses, social care and other safeguarding partners. We saw examples where concerns had been identified and acted upon promptly, including a child safeguarding concern identified during registration and a review of proxy access arrangements for young people, which resulted in strengthened processes to support confidentiality and safeguarding responsibilities.
 

The practice supported people to understand and manage risks associated with their health and care. Patients with long-term conditions were monitored through structured review processes, and the practice took additional steps to contact people who did not attend appointments or engage with reviews. This helped reduce the risk of important monitoring being missed.
Staff identified carers, vulnerable patients and people with additional needs, and discussed their support needs through multidisciplinary forums where appropriate. Reasonable adjustments were recorded and used to tailor care, including access to interpreters, longer appointments and alternative consultation methods. This helped patients access care in a way that met their needs and supported their involvement in managing their health.
Reception and administrative staff had received training to recognise potentially unwell patients and could seek immediate clinical support when concerns were identified. Urgent appointments were available when required, helping ensure deteriorating patients received timely assessment and treatment.
 

The practice had arrangements in place to manage environmental risks and support the safety of patients, staff and visitors. However, we identified some gaps in oversight and record keeping which required improvement.
When concerns were identified, action was taken to address them. For example, additional legionella testing and remedial work were completed following concerns about water temperatures.
Fire safety arrangements were established and included regular testing, drills, and maintained equipment. The practice had acted on recommendations from a recent fire risk assessment and had completed actions identified to improve safety within the premises. However, records relating to some safety checks were not always maintained effectively. Following the assessment, the practice implemented measures to strengthen record keeping and provide greater assurance that required checks had been completed.
The premises were accessible and generally well maintained. Clinical and patient areas were clean, tidy and uncluttered, and equipment used to support patient care was serviced, calibrated and regularly checked. Emergency equipment was readily available to support staff in responding to medical emergencies. At the time of the assessment, not all emergency medicines were available. Following the assessment, the practice took action to address this and ensure appropriate emergency medicines and equipment were available.
 

The practice had systems to ensure staff were suitably recruited, trained and supported to carry out their roles safely. Recruitment processes included checks to confirm identity, right to work and criminal record status where required. New staff completed an induction programme to support them in understanding local processes and expectations.
Training compliance was monitored through electronic systems and staff completed mandatory and role-specific training relevant to their responsibilities. Clinical staff maintained professional registration requirements and participated in continuing professional development to support safe and effective practice.
Leaders demonstrated a proactive approach to workforce planning and had recently recruited additional clinical staff to strengthen capacity. Staff told us they felt supported by leaders and were able to access advice, training and supervision when needed.
 

The practice had arrangements in place to prevent and control infection. An identified lead provided oversight of infection prevention and control, supported by regular meetings, staff training and audit activity. Clinical waste was managed appropriately, and systems were in place for the safe disposal of waste and sharps.
Clinical areas were clean and uncluttered, with suitable handwashing facilities, personal protective equipment and cleaning materials available. Waiting areas were spacious and furnished in a way that supported effective cleaning. Patient feedback regarding hand hygiene had been used to improve staff awareness and increase patient confidence in infection prevention practices.
Although leaders had identified and responded to infection control risks, further work was required to strengthen oversight of cleaning arrangements. We found some cleaning equipment was not being used or managed in line with recognised guidance and there was insufficient assurance that reusable cleaning equipment was cleaned and maintained appropriately between uses. While infection prevention and control audits were completed, these issues had not been fully identified through existing monitoring processes.
At the time of the assessment, the provider did not have a formal governance process in place to monitor staff immunisation status. This meant leaders were unable to evidence oversight of whether staff had received vaccinations relevant to their role. Following the assessment, the provider supplied evidence that a monitoring system was being developed and staff records were being reviewed. This demonstrated that leaders had taken action to improve oversight and strengthen assurance regarding staff immunisations.
 

The practice had effective systems for managing medicines safely. Prescribing activity was overseen by designated clinical leads who monitored patient safety alerts, prescribing risks and medicines-related searches. Patients who were prescribed medicines requiring ongoing monitoring were supported through structured review processes designed to ensure monitoring remained up to date.
The practice used audits and quality improvement activity to review prescribing and identify opportunities to improve patient care. Where medicines-related incidents occurred, these were investigated and learning was used to strengthen practice and reduce future risk. Staff demonstrated an understanding of prescribing responsibilities and systems were in place to support safe decision making.
Medicines were stored appropriately and arrangements were in place for stock control, expiry date monitoring and temperature checks. At the time of the assessment, arrangements for recording and monitoring prescription serial numbers were not in place. Following the assessment, the practice provided assurance that a system had been introduced to strengthen oversight of prescription stationery.