Wolstanton Medical 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 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. The representative from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. They told us the provider listened to any concerns raised and apologised when people’s expectations had not been met. 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 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. For example, the development of an information postcard/pack to support people and their families requiring end of life care.

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 people 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.

Systems and processes were in place to identify and raise awareness of groups of people who were potentially at risk. Safeguarding concerns were discussed with all staff at the monthly practice meetings. The safeguarding lead and care coordinator reviewed the children’s safeguarding register on a regular basis and updated individual records as required. The safeguarding lead also attended the multidisciplinary children’s safeguarding meetings coordinated by the local authority. There were systems in place to follow up people who failed to attend appointments in primary and secondary care or were frequent attenders of out of hours or accident and emergency services.

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.

Systems were in place to check emergency equipment and medicines. Most of the recommended emergency medicines were available within the practice. Medicines not stocked had been risk assessed as not required in the practice.

Staff could recognise a deteriorating patient and knew of the actions to take. Staff had attended sepsis awareness training and reception staff had ‘red flag’ flow charts to follow to direct people appropriately. People were advised on risks related to their condition and actions to take if their condition deteriorated. The provider shared a positive example of staff action in response to a medical emergency in the service.

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

A fire risk assessment had been completed, and staff completed online fire safety training and attended regular fire drills. A legionella risk assessment was in place and the one outstanding action had been scheduled for completion during the next financial year. Regular testing of water temperatures took place. Electrical and medical equipment had been tested and calibrated as required.

The electrical installation report completed in December 2022 indicated the condition was unsatisfactory. We saw evidence the required actions had been completed and appropriate certification in place.

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. Staff were positive about the support, training and development they received.

The GP registrars and trainees, and staff working in advanced roles were supported with regular debrief sessions and feedback on the quality of their consultations and prescribing.

Safe recruitment practices were followed.

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 service had a designated infection, prevention and control lead and all staff had completed relevant training. Risk assessments and audits were completed, and actions taken or planned to mitigate identified risks.

Staff were required to clean touchpoints within the building at specific times during the day. Touchpoint QR codes were in each room for clinical staff to scan. We saw that the result of the touchpoint was stored electronically on their IT system.

Cleaning schedules were available throughout the building. The cleaning company was unable to share the completed electronic cleaning schedules and as a consequence the service had introduced a paper checklist for them to sign off each day. The cleaning company carried out regular audits and these had been shared with the service on request.

Staff vaccination was maintained in line with current UK Health and Security Agency (UKHSA) guidance if relevant to their role.

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. Medicine reviews were appropriate and generally well-structured. Processes were in place to provide assurance on the quality and safety of non-medical prescribing.

The service had effective systems to manage and respond to safety alerts and medicine recalls. Our remote clinical searches found established and effective processes were in place to ensure people prescribed medicines with specific risks received the recommended monitoring. Issues identified were addressed immediately by the provider and a new protocol added to the practice’s IT system to alert clinicians to potential risks at the point of prescribing.

There was a highly effective system in place for tracking prescription stationery throughout the practice. This included a weekly manual audit completed by the practice manager and an electronic audit to monitor that the audit completed by the practice manager was accurate and correct. On the day of our assessment, we found clear and accurate lines of tracking.

Staff regularly checked the stock levels and expiry dates for all medicines and vaccines. Medical gases, such as oxygen, were stored securely.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. However, prescribing data reviewed as part of our assessment indicated the number of antibacterial prescription items issued by the provider was higher than the national average.