Park Lane 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 66 (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.

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. Managers encouraged staff to raise concerns when things went wrong.

Systems were in place to discuss, learn from and disseminate information from clinical issues or learning events. 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. Staff felt there was an open culture, and that safety was a top priority. The Incidents were discussed and learning disseminated through staff meetings. Learning from incidents and complaints resulted in changes that improved care for others. For example, review of policy and procedure for processing notifications of death and increase the length of appointments following feedback from people.

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. Local health care providers used the same electronic patient record system and could easily access information about people using the service.

There were systems in place for processing information relating to new patients. The provider was part of a trial for automatic registration via the NHS website. This enabled people to register directly with the service through the NHS website and the information linked directly into the electronic patient record.

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.

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. The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations.

Systems and processes were in place to identify and raise awareness of potentially vulnerable groups of people. Safeguarding concerns were discussed at the weekly clinical meetings in addition to the monthly internal safeguarding meeting. Monthly multidisciplinary team meetings were also held to discuss vulnerable people in need of additional support. There were systems in place to follow up people who failed to attend appointments in primary and secondary care or were frequent attenders to the emergency department.

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. A spare set of defibrillator pads were not available, however the service confirmed these had been ordered following our assessment. Effective systems were not in place for checking the expiry dates of consumables, as out of date syringes, blood bottles and needles were available in two rooms.

Staff could recognise a deteriorating patient and knew of action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Contracts were in place to ensure the premises were maintained. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed. 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. Staff told us there were sufficient staff to meet the needs of people although the provider should consider whether additional nursing team hours would be beneficial to reduce the waiting time for appointments.

There were a range of clinical and non-clinical roles within the practice. We 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. Staff were positive about the support, training and development they received. Staff working in enhanced roles told us support from GPs was always available, although a formal system for regular audit of their prescribing and consultations was not in place. Following our assessment, the provider told us they planned to implement a formal system for reviewing prescribing and consultations.

Safe recruitment practices were followed.

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. Improvements had been made to the systems in place to assess and manage the risk of infection. The service had a designated infection, prevention and control (IPC) lead and all staff had had relevant training.

Recent audits had highlighted issues with the standard of cleanliness with the building. As a consequence, the service was working closely with a new external cleaning contractor to improve the standard of cleanliness. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks. Clinical waste procedures were in place.

Staff vaccination was maintained in line with current UK Health and Security Agency (UKHSA) guidance if relevant to their role.

Overall 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.

Our clinical searches identified people prescribed a disease-modifying antirheumatic medicine were generally well managed. However, the instructions on the prescription did not always include the day of the week for administration.

Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. However, our clinical searches identified although most people received the recommended monitoring, it was not always at the frequency required.

Staff regularly checked the stock levels and expiry dates for all medicines and vaccines. The recommended emergency medicines were available within the practice, and a risk assessment in place for the one medicine not kept in stock. Medical gases, such as oxygen, were stored securely.

Prescription stationery was stored securely. We looked at the system in place to record the receipt and use of prescription stationary. The log held was inaccurate. There were 3 boxes of prescription stationery, 1 open and in use and 2 unopened. The log did not record when the boxes had been received, the box number or the prescriptions numbers, so it was not clearly recorded which box was in use. There was a system for tracking prescription stationery through the service. Staff were not aware of the sequential nature of the serial numbers on prescription stationery.

National prescribing data showed the practice was a high prescriber of medicines used to treat uncomplicated urinary tract infection (UTI). Our searches identified that courses in excess of the recommended 3 days were being prescribed. The provider told us people with uncomplicated UTIs were seen by the community pharmacist and more complex cases were seen at the service. The provider told us they considered the doses prescribed were justified but this would be discussed further with the clinicians.