Caythorpe & Ancaster Medical Practice

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

This service scored 78 (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 strong and proactive learning culture of safety, based on staff being encouraged to be open and honest. The practice took concerns seriously and thoroughly investigated them. Lessons were shared with the team. The practice evaluated trends and themes of significant events and complaints. Representatives from the PPG felt the practice were open to discussing concerns with them and were willing to take input from them on various areas concerning improving the practice. Staff felt there was an open culture at the practice. The practice followed its complaints policy and provided detailed and well investigated responses. The practice sought to seek local resolution where able. Clinicians reflected on the care they provided and thought about how to improve communication with people so that people received consistently high quality consultations.

The practice always worked with people and healthcare partners to design, establish and maintain safe systems of care. The practice provided minor surgery contracts in the local area. This service was well run and managed. There was evidence of continuous improvement of this service through service review, comprehensive audits and people’s feedback. There was a well-established working relationship with the Dermatology service at the local hospital for enhancing clinical skills and multidisciplinary team working. People that were referred into this service were appropriately followed up and next steps were communicated to patients. This service had a positive impact for people as it provided a service in a rural community where people may struggle to access secondary care easily. We saw an example where an elderly person who would have struggled to access hospital services was accommodated at the practice through multidisciplinary team working. A positive outcome was achieved for this person. The practice worked with local services to deliver shared care and referrals were managed in a timely way. A previous significant event led to a new protocol for managing referrals in house which created a more robust system. This has ensured people receive a timely referral and that referrals are appropriately reviewed by the practice. Test results were dealt with appropriately.

The practice maintained a good standard of care to ensure vulnerable people were reviewed and safe. The practice engaged in multidisciplinary team working to ensure people had comprehensive care. The practice had a clear process for sharing concerns and staff were aware of how to raise these. Safeguarding leads were in place at the practice and they worked with external stakeholders to ensure vulnerable people were receiving appropriate care. The safeguarding register was well maintained and the practice had a well-developed system to review people on a regular basis. The practice had a good understanding of people on the register and regularly reviewed any updates in relation to care. They appropriately monitored the register for new people who were added.

The practice worked with people to understand and manage risks where appropriate. They provided a holistic approach, encompassing social factors and patient wishes. The practice did this through consultations but also provided relevant information leaflets for high-risk medicines so people could make an informed choice regarding their care. Emergency equipment was available and well maintained. Staff could recognise a deteriorating person and knew how to take action in an emergency.

The practice carried out a health and safety risk assessment which was satisfactory. A business continuity plan was in place and reviewed regularly. The practice was compliant with their fire risk assessment. We saw evidence of a local legionella risk assessment having been carried out. A more comprehensive risk assessment was carried out by an external company promptly following our on site visit.

The practice had an extensive mix of qualified, skilled and experienced staff. They ensured people had access to appropriate clinicians. The practice proactively monitored staffing in response to how many patients needed to be seen for urgent and routine appointments to ensure they met need. Staff were well supported and the practice had a strong ethos around supervision of staff. The practice was keen to develop staff and gave them opportunity to do so. The practice engaged with external speakers to give learning sessions to the practice, most recently on the latest asthma guidance. This ensured clinicians were giving people appropriate care. They also ran their own in-house tutorials to engage various clinical groups within the practice. This benefited people as they were receiving care that was following guidance and standardised across clinicians. This gave staff the opportunity for self-development and sharing ideas amongst clinicians. The practice evidenced strong communication between staff members to ensure good outcomes for patients. All training was up to date. Staff had appraisals. The practice followed a safe recruitment process and ensured comprehensive induction for new staff members.

The practice assessed and managed risk of infection. The practice carried out an infection, prevention and control audit which was effective. The practice was visibly clean and maintained to a good standard. The practice had an infection, prevention and control lead and all staff had relevant training. People were able to access care in safe surroundings. We did see evidence that cleaning schedules were not always up to date. The practice plan to address this to ensure consistent monitoring of the standard of cleaning.

Medicines including controlled drugs (medicines requiring additional security measures due to their potential for misuse) were stored safely and securely.Systems and processes were in place to ensure that when people ordered their repeat medicines, these were processed and dispensed where appropriate in a timely manner. Staff had the appropriate authorisations to administer medicines under a Patient Group Direction or a Patient Specific Directions.There were regular reviews of non-medical prescribing practice supported by clinical supervision and auditing of the effectiveness of staff consultations and prescribing.The practice had systems to manage and respond to safety alerts and medicine recalls. Regular medicines reviews were carried out to ensure patient medicines were appropriate to their needs.Dispensary staff had relevant training and competency assessments to their role and told us they felt well supported by the senior leadership team. There was a good culture around reporting of medicines related errors, and processes were in place to ensure that these were investigated, and that learning was shared with staff.As part of the assessment, we conducted searches of the practice clinical records system. The searches and records we reviewed showed that people were managed appropriately in relation to medicines which required monitoring. There was a clear process in place to ensure people with long term conditions were followed up and received appropriate care.