Bannockburn PMS

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 inadequate. At this assessment, the rating has changed to good.

The service was in breach of legal regulation in relation to regulation 12 (safe care and treatment) due to some emergency equipment not being present. We have asked the provider for an action plan.

This service scored 69 (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. All of the staff to whom we spoke were familiar with the process of raising concerns, and they told us that they were encouraged to do so. 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. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. The complaints that we reviewed had been managed in line with the provider’s own policy and best practice guidance. 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.

At our last inspection we found there was a lack of a formalised process for the receipt of notifications from the Medicines and Healthcare products Regulatory Agency (MHRA). At this inspection we found that the system had been altered so that these notifications were clearly managed.

There were systems in place for processing information relating to new patients. The service worked with other providers to deliver shared care and when patients moved between services. Referrals and test results were managed in a timely way.

At our last inspection there was a lack of clarity about safeguarding leads and processes. At this inspection we found that a formalised safeguarding structure was in place, and all of the staff to whom we spoke knew who to contact with safeguarding concerns. Staff were able to provide examples of when they had raised concerns and how they had been managed. 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 did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

At our last inspection we found that the service did not always detect and control potential risks in the care environment. At this inspection we saw that there were a range of risk assessments in place which were monitored, and changes implemented as required. The service detected and controlled potential risks in the care environment. In most cases they ensured equipment, facilities and technology supported the delivery of safe care. However, we saw that a piece of equipment was missing from the emergency equipment. This was a portable suction device for an airway emergency, but the relevant tubing was not available which was a risk to patient safety if their airway was blocked or impaired.

Contracts ensured 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 which was monitored and reviewed.

At our last inspection we found that staff we not always suitably qualified for the work they were asked to complete, and that staff were not always working within their areas of competency. At this inspection we found that roles and responsibilities had been clarified and that all staff were working within the limits of their competence. However, the service did not have formalised supervision arrangements for non-medical prescribers at the practice.

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. However, there were no formalised meetings with non-medical prescribers, or any other formal means by which their individual clinical work could be reviewed. Safe recruitment practices were followed.

At our last inspection we found that the provider did not always assess or manage the risk of infection. At this inspection we found that 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 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.

At our last inspection we found that the service did not always make sure that medicines and treatments were safe. At this inspection, we found that 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. Staff managed prescription stationery appropriately and securely. Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring. Medicines 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 took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. We undertook clinical searches of the service’s clinical databases. We found that clinicians were monitoring medicines in line with best practice and requesting blood tests where required. There were systems to ensure that patients complied with the requests for blood tests, including reducing the quantity of medicines prescribed until such time that they were complete.