Kingstone 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 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 practice had a proactive and positive culture of safety, based on openness and honesty. There were clear processes for staff to report incidents, near misses and safety events. Staff were encouraged to raise concerns and report incidents which were discussed at regular meetings. Learning from incidents resulted in changes that improved care for others. Patients told us they felt supported to raise concerns and felt staff treated them with compassion and understanding.

The practice worked with patients and healthcare partners to establish and maintain safe systems of care. They made sure there was continuity of care, including when people moved between services. There were protocols in place for managing incoming correspondence into the patient’s medical records. This included appropriate arrangements for the oversight and recording of laboratory results. Patient referrals to specialist services were documented in the referrals systems and patient record. We found test results and referrals were managed in a timely manner. This reflected the feedback we received from patients.

Safeguarding policies and processes were in place to keep people safe and safeguarded from abuse. The practice had a safeguarding lead, and all staff had completed the relevant safeguarding training for their role. Staff had also received domestic abuse training. The practice had a register for vulnerable adults and children and there was evidence that this was regularly reviewed and updated. Clinical system alerts were used to identify people who were at risk of harm or abuse including household contacts. There were systems in place to respond to concerns and act on correspondence. For example, they followed up children who failed to attend their appointments and A&E attendances. Safeguarding meetings were held on a regular basis to review people at risk which included external professionals such as health visitors.

The practice worked well with patients to understand and manage risks. They provided care to meet people’s needs that was safe and supportive. Our review of a sample of consultation records showed that most patients were informed about risks related to their condition and actions to take if their condition deteriorated. There were processes in place to ensure care was prioritised for their most clinically vulnerable patients. Staff could recognise a deteriorating patient and knew of action to take.

The practice detected and controlled potential risks. There were policies and procedures in place for the management of health and safety. They made sure equipment, facilities and technology supported the delivery of safe care and met people’s needs. Systems were in place for the checks of fire alarms, fire extinguishers and fire evacuation procedures. Portable appliance testing was completed annually to ensure equipment was safe to use. The practice had a legionella risk assessment in place that showed the risks were low and were properly managed. The risk assessment stated it should be reviewed on an annual basis. We found it had not been updated since 2022. The practice updated this following our visit.

There were enough qualified, skilled and experienced staff, who received effective support, supervision and development. We reviewed 5 personnel files and found appropriate checks such as previous employment record, proof of identity and references had been completed. We found most staff immunisation status records were in place and there was evidence of gaps being followed up. Staff received appropriate training and told us they felt supported with their personal development and were given opportunity to learn.

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. Cleaning schedules were in place and followed. The practice had a designated infection, prevention and control (IPC) lead and all staff had completed relevant training. The practice had a regular and comprehensive audit programme, and actions were taken to mitigate risks. The practice shared evidence that they had recently scored highly on an IPC audit which looked at areas such as hand hygiene, waste and environment.

The practice made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. There was a system in place to ensure all information including documents, laboratory test results and cytology reports were reviewed and actioned in a timely manner. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines and controlled drugs. There were suitable processes for staff to follow when dispensing medicines. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. As part of our inspection, a series of patient clinical record searches were undertaken by a CQC GP specialist advisor. This included a review of the management of patients on medicines that required monitoring. We found most patients had received monitoring in line with guidance. We discussed our findings with the practice, and they took immediate action to follow up on the gaps identified. Systems for managing the prescribing of medicines were safe and met people’s needs. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued by the provider was hiin line with national averages.