Abbottswood 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 practice had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns, reported and investigated them. The practice had processes for staff to report incidents. Lessons were learnt to continually identify and embed good practice. For example, following an emergency incident, the practice reviewed what had happened, what worked well and what could be improved. The practice updated their incident policy to include the changes suggested by staff following this incident. Managers encouraged staff to raise concerns that were later discussed in meetings. People felt supported to raise concerns and felt staff treated them with compassion and understanding. Learning from complaints resulted in changes that improved care for others. Representatives from the Patient Participation Group (PPG) felt the practice took concerns seriously and improvements were made to the service following feedback from the PPG.

The practice worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. The practice worked with other providers and services to ensure continuity of care, including when people moved between different services. There were systems in place for managing incoming correspondence for patient’s medical records, including processing information relating to new patients. There were automatic recall systems in place, including text message reminders for patients. Staff ensured pathology and blood test results were reviewed and actioned in a timely manner. For example, the practice operated a ‘buddy system’ to ensure all results were reviewed the same day they were received. Staff understood the referral system and were able to tell us about the process when dealing with referrals, ensuring they were followed up accordingly. Triage systems were in place for staff to follow.

The practice 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 practice shared concerns quickly and appropriately. Staff had completed safeguarding training so knew how to identify, report and act when dealing with safeguarding concerns.

The practice had an effective system in place for the management, oversight and reviewing of safeguarding concerns. Safeguarding policies were in place that were regularly referred to, to help decide the next steps to ensure each patient was dealt with appropriately. They worked well with other healthcare professionals to ensure the concerns were addressed appropriately. Staff were aware who the safeguarding lead was.

The practice maintained a list of vulnerable people that was reviewed regularly and updated. The practice also ran searches every 6 months to ensure all patients on the register were accurate. Vulnerable people were coded on their system and had alerts added to their records, including household contacts. Safeguarding meetings were held every 8 weeks where vulnerable patients were discussed. The practice had a chaperone policy in place to maintain patient privacy during intimate examinations. Posters were displayed in consultation rooms and waiting areas.

The practice worked well with people to understand and manage risks. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. 93%of respondents to the National GP Patient Survey felt they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment. This is higher than the national average of 91%. Staff were able to recognise a deteriorating patient and knew what action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated. For example, our clinical search of patient records for those prescribed mirabegron (a medication prescribed to treat an overactive bladder), had all been informed of the risks. Emergency equipment was available and regularly checked.

The practice detected and controlled potential risks in the care environment. The practice had procedures to ensure equipment, facilities and technology supported the delivery of safe care. Audits had been completed and the risks identified had been addressed. There was a business continuity plan in place which was reviewed and updated accordingly. Portable appliance testing and calibrations had been completed to ensure equipment was safe to use. Systems were in place to check safety equipment including fire alarms and panic buttons. Fire evacuation drills were completed. During the onsite visit, the premises were visibly clean and tidy. Cleaning schedules were in place to maintain a clean, safe environment.

The practice made sure there were enough qualified, skilled and experienced staff that worked well together to provide safe care and meet people’s individual needs. Leaders explained their recruitment processes to ensure appropriate numbers of suitably trained staff were employed to support the delivery of good quality care which met the needs of the patients.There were a range of clinical and non-clinical roles within the practice. Staff were working within their agreed areas of competence. We reviewed personnel files during the onsite visit and found that most of the necessary recruitment documents were accessible in the staff files, except for staff immunisation records. The practice acknowledged this feedback and have since provided us with evidence of staff immunisation records and have updated their pre-employment checklist to ensure all required information is gathered. Staff were up to date with their mandatory training and had annual appraisals conducted by their team leader whereby learning and development was discussed.

The practice assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns promptly. The practice had a designated infection, prevention and control (IPC) lead and staff were aware of who this was. Staff had completed appropriate IPC training relevant to their role. Staff told us they knew their roles and responsibilities around IPC. Cleaning schedules were in place and followed to ensure the premises and equipment were kept clean. IPC policies were in place and IPC audits were completed and the appropriate actions were taken when necessary to mitigate any risks. However, during the site visit numerous used sharps bins were found not dated or labelled. The practice acknowledged this feedback and have since circulated the sharps bin protocol to the relevant staff and labelled the sharps bins accordingly.

The practice made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes were made to their medicines. Staff involved people in reviews of their medicines and helped them to understand how to manage their medicines safely. Clinical audits were completed that focused on improving patient care and treatment.

Staff regularly checked medicine stock levels and expiry dates, including emergency medicines and controlled drugs. However, the practice did not have all necessary emergency drugs available and there was no risk assessment for this. The practice acknowledged this feedback and took immediate action to stock the missing emergency drugs. Medical gases such as oxygen were stored safely. Fridge temperatures were monitored, and staff knew what action to take if the temperature was out of range. There were patient group directions (written instructions to help specific healthcare professionals supply or administer medicines to patients)in place which relevant staff worked to.

As part of our assessment, our CQC GP specialist advisor carried out remote clinical searches of patient records to evaluate whether clinicians were prescribing a range of medicines safely. Our clinical records review identified that all patients prescribed methotrexate or azathioprine(immune system suppressant drugs) were monitored in line with guidance. We reviewed a random sample of 5 medication reviews out of a total of 605 reviews that had been completed for patients in the previous 3 months and found that all 5 patient records had been appropriately reviewed. The practice had effective systems to manage and respond to safety alerts and medicine recalls. We found the dispensary had appropriate protocols in place for staff to follow to ensure they dispensed medicines safely. Patients told us they received their medicines in a timely manner.