Morland Road 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 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. GPs we spoke with gave examples of incidents that had occurred and outlined how they were dealt with and lessons learned.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. Representatives from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. However, some felt the practice could do more to share details when events happened.

Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical issues. We saw meeting minutes to confirm this.

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.

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 practice manager was responsible for summarising all new patient notes. Patients were generally registered online however paper registration was available to vulnerable people and anyone else who preferred this method.

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. GPs told us that all results that came in were looked at on a daily basis. If the patient needed to be contacted a text message was sent to them. If tests were abnormal, patients were contacted by phone immediately.

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.

Whilst the practice had oversight of vulnerable patients and children subject to child protection orders they did not maintain a list of vulnerable people. We saw that despite not having a list, GPs acted on concerns working in partnership with other organisations. We discussed the lack of a written list, and the practice assured us they would review this. Shortly after the site visit, they contacted us to confirm this had been actioned.

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.

Emergency equipment was available and maintained. We saw records of the regular checks undertaken on a monthly and weekly basis. Staff completed basic life support training on an annual basis. We saw certificates to confirm this.

Staff could recognise a deteriorating patient and knew of action to take. GPs told us that reception staff would always discuss with them if there was a patient who needed to see a clinician and didn’t have an appointment. They said all patients were seen if they attended the practice and never turned away even if they had to add additional appointments.

Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

The service did not always detect and control potential risks in the care environment. Whilst equipment and technology supported the delivery of safe care, this was not always the case for facilities.

Internal health and safety risk assessments and audits had been undertaken and risks identified had been addressed. However, the fire and legionella risk assessments were overdue, although we did not identify any areas of concerns in these areas, other than the lack of up-to-date assessments. The provider had identified this prior to our visit and planned for them to be carried out shortly after our site visit. The reports of the visits from the external contractors were shared with us.

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 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 reviewed the training matrix and 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. Safe recruitment practices were followed. Our review of staff recruitment records confirmed this.

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. They were carrying out regular audits, however the template used required updating to ensure they were picking up things in line with current national infection control guidance. Cleaning schedules were in place and followed. Risk assessments and audits were completed, 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 involved people in reviews of their medicines and helped them understand how to manage their medicines safely. The pharmacist was responsible for carrying out medicine reviews and discussed outcomes with GPs when necessary.

People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms.

Staff received regular training, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines.

Most prescriptions were given electronically. Staff told us they very rarely used paper prescriptions however prescription stationery was managed appropriately and securely.

Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring.

Medicines including controlled drugs were stored securely and at appropriate temperatures. For example, the practice had processes in place to monitor fridge temperatures. Procedures were in place to respond to an event of a fridge failing and temperatures going outside of range.

Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. We saw records of the checks carried out. 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. All alerts were processed and actioned by the pharmacist. All relevant information was shared with the team as appropriate.

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