The Summerhill 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.

Systems were in place to protect individuals from abuse and avoidable harm, with safety clearly prioritised across the service. The provider responded seriously to concerns, and feedback from people using the service indicated they felt safe and well cared for. Safety incidents were investigated, and learning was used to identify shortfalls and prevent recurrence.

Safeguarding procedures were well established to protect those at risk, and services were designed around individuals to support safe transitions between care settings. People were supported to understand their care, enabling informed choices that reduced the risk of harm.

Leaders ensured there were sufficient numbers of appropriately skilled staff in place to deliver safe care. Pre-employment checks were completed, and staff received safeguarding training relevant to their roles, alongside regular appraisals and ongoing training to maintain high standards.

Health and safety procedures were in place, and the premises were appropriately maintained. Systems for monitoring patients’ health in relation to medicines, including those requiring regular review, were effective. Areas for improvement identified during the assessment were promptly addressed by the provider.

This service scored 72 (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 positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. People felt supported in raising concerns and reported that staff treated them with compassion and understanding. Managers fostered a culture where staff were encouraged to speak up when things went wrong. However, learning from incidents was typically shared with the relevant departments, rather than across the entire team.

The provider had a duty of candour policy and involved people when managing significant events and errors and had a clear system in place to record and investigate complaints. From the sample of complaint records we reviewed; we found the provider responded to people’s complaints in a timely manner. The provider offered apologies to people, lessons were learnt from individual concerns and complaints and action was taken as a result to improve the quality of care.

The service collaborated with individuals and healthcare partners to establish and maintain safe systems of care, with clear processes in place to manage and monitor safety. Continuity of care was prioritised, including during transitions between services. Systems were in place for processing information related to new patients and for delivering shared care in partnership with other providers. For example, timely referral pathways were established for access to appropriate services, and a documented process was in place for the management and follow-up of test results. Buddy arrangements ensured that test results were actioned in the absence of a GP, supporting safe and consistent care delivery.

The provider had a safeguarding lead for adults and children and held a safeguarding register. Safeguarding policies were in place and staff were appropriately trained in safeguarding procedures. The provider maintained a list of vulnerable people and acted on concerns working in partnership with other organisations. Clinical records we reviewed showed that they had been appropriately coded where safeguarding concerns had been identified. There were processes in place to follow up children and young people who were not brought to their appointments both at the practice and for secondary care appointments. Safeguarding meetings were held on a regular basis to review people at risk and community teams were invited to ensure information was shared appropriately for the care of people with safeguarding and vulnerable concerns. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. For example, the provider regularly liaised with multi-disciplinary teams to coordinate the care for elderly residents living in care homes. 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 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. For example, there were regular primary care meetings held with other agencies so that care met patients’ needs and services managed care holistically. The provider also had registers in place to support those patients who were vulnerable or who had mobility or communication needs.

Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and knew the action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

The premises were clean and contained the appropriate facilities to support infection prevention and control.

The provider detected and controlled potential risks in the environment. They made sure equipment, facilities and technology supported the delivery of safe care. Regular checks were carried out on the premises, facilities and equipment provided. Contracts were in place to ensure the premises were clean and well maintained. Clear signage around the building supported people and staff in the event of an emergency evacuation.

Some areas of the practice premises required ongoing maintenance. Observations noted uneven external paving, as well as parts of the building in need of repainting and general refurbishment. Risk assessments had been completed, and the provider informed us that plans were in place to modernise the site and address these concerns.

Health and safety related assessments and procedures to manage health and safety were in place. This included fire safety. Staff had been provided with training in health and safety related topics such as fire safety, infection control and manual handling. Staff reported during discussions and in feedback forms that they had no concerns regarding the arrangements in place to ensure health and safety.

A business continuity plan was in place to provide structured guidance in the event of major service disruptions, such as IT system failures.

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. The provider employed a range of clinical and non-clinical staff, and management had systems in place to calculate and regularly review the staffing to patient ratio, identifying and addressing any gaps as needed. At the time of our assessment, a new nurse had recently been appointed. Staff consistently described leaders and managers as approachable and supportive.

Staff training was up to date, and learning needs were appropriately identified and supported. Staff were working within their defined areas of competence. However, there was limited evidence of formal supervision or routine audits for non-clinical prescribers. The practice reflected on this during the assessment and took prompt action to implement a formal policy and conduct an audit of non-medical prescribers to strengthen oversight and assurance.

A recruitment policy was in place, and a review of personnel files confirmed that safe recruitment was consistently followed. Records of staff immunisation status were maintained, and all staff had completed annual appraisals. New staff participated in a structured induction programme and were required to complete mandatory training within appropriate timeframes. Staff were supported to deliver safe care through access to relevant training and development opportunities

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 provider had policies in place for infection, prevention and control which was accessible to staff. The provider 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.

The service made sure that medicines and treatments 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 received regular training and felt confident managing the storage, administration and recording of medicines. 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 routinely monitored stock levels and expiry dates for all medicines, including emergency medicines and vaccines. However, the provider was unable to provide evidence of the rationale for not stocking two specific emergency medicines. Immediate action was taken during the site visit to address this gap.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Appropriate action had been taken in response to the medicines alert we looked at. We reviewed clinical records for patients who had been prescribed medicines which required routine monitoring. Our review showed that medicines were managed safely and the approach to medicines reflected current and relevant best practice and professional guidance. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. Our review of the patient clinical record system showed that patients who were prescribed high risk medicines were being monitored effectively. We noted that a small number of patients were overdue checks relating to their medicines. The provider told us how they had addressed this immediately following our assessment.