Park 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. The rating remains good following this assessment.

Systems were in place to protect people from abuse and avoidable harm. We found safety was a priority, and the provider took concerns seriously. Feedback from people who used the service indicated that they felt they received safe care and treatment. The provider acted upon feedback from people and made improvements to the service in response. Safety events were investigated, and lessons were learnt to identify any shortfalls, prevent a recurrence, and embed good practice. Overall, members of the staff team provided positive feedback about staffing levels. Systems and procedures were in place to safeguard patients who may be at risk of abuse. Staff had undergone checks to ensure they were suitable for employment, and they had been provided with safeguarding training at a level appropriate to their role. Oversight of staff training ensured that staff had undertaken training to meet their roles and responsibilities. Procedures for managing health and safety and checking the safety of premises and equipment were in place. There were processes for monitoring patient’s health in relation to the use of medicines including medicines that require regular review. We found that overall medicines were managed safely, however we identified some areas for improvement that were addressed by the provider during the assessment.

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 proactive and positive culture of safety, based on openness, honesty and transparency. Processes were in place for staff to report incidents, near misses and safety events. The provider listened to concerns about safety and investigated appropriately. Staff felt there was an open culture based on trust, and that safety was a priority. The provider held a log of significant incidents and a log of complaints which they used to identify themes, trends and learning. When things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that improved care for others.

Staff told us they were supported to identify their training needs and protected learning time was provided for them to undertake training, learning and professional development. Training was provided within the service and through attendance at locality wide training and educational events.

The service collaborated with people and healthcare partners to establish and maintain safe, effective systems of care, in which safety was managed or monitored effectively. Members of the staff team were aware of local services and support networks that they could refer patients to support them with their needs and to prevent ill health.

Regular multi-disciplinary meetings were held where patients with more complex needs or those approaching the end of life could be discussed.

Triage systems and protocols were in place for staff to follow. Referrals to secondary or specialist care were made promptly, patients referred under the two week wait rule for suspected cancer were followed up appropriately. Urgent referrals were monitored to ensure patients attended appointments and clinicians followed up their own referrals to ensure patients were contacted by the hospital.

People could request a chaperone for intimate examinations if they wished and there was information to alert them to this in the waiting room and in clinical rooms.

The service worked to safeguard people from the risk of abuse. There were systems and processes to respond when it was suspected that people may be subject to abuse or neglect. The service maintained a list of vulnerable people and acted on concerns working in partnership with other organisations. Safeguarding policies were in place, and accessible to staff.

Staff had been provided with safeguarding training at a level that was appropriate to their roles and responsibilities and had a clear understanding of safeguarding. The service had a designated lead for safeguarding adults and children at risk and staff were aware of this. They knew the action to take if they had concerns about a patient’s safety and they told us they would feel confident to report concerns. Alerts were added to the patient record system when a patient was subject to a safeguarding concern so that all relevant members of the staff team could readily identify this.

The service worked with people to understand and manage risks. They provided care and treatment to meet people’s needs that was safe, supportive and encouraged people to remain healthy. Patients were advised on risks related to their condition and actions to take if their condition deteriorated. Friends and Family feedback shared by the practice from people who used the service indicated that they were provided with a good level of information about their condition enabling them to make informed decisions about treatment and risks. Patients were referred to services that could provide them with specialist advice to manage their condition and the risk of deterioration. Staff worked proactively to support patients with the prevention of ill health, for example, recalling patients who were at risk of developing diabetes or referring patients for dietary advice. Patients were called in for regular checks on their health when they were living with a long-term condition.

Our review of the patient clinical record system showed that overall patients who were prescribed high risk medicines were being monitored effectively, however some patients had not received a full review to monitor their condition. The provider acted during the assessment to address this shortfall.

The service was in a building that provided the required facilities such as safe access for people with physical disabilities, although disabled parking was limited on site.

The provider detected and controlled potential risks in the environment; however, they did not always make sure equipment, and facilities supported the delivery of safe care. For example, blind cords in two examination rooms were not secured appropriately and posed a potential ligature risk, floor tiles were loose on the third-floor landing and the outside clinical waste bins had recently been emptied and were not locked. These observations were discussed during our assessment, the provider was receptive to our feedback, and we received appropriate assurance the issues would be addressed.Regular checks were conducted on the premises, facilities and equipment provided and contracts were in place to ensure the premises were clean and well maintained.

Health and safety assessments and procedures were in place. Staff had been provided with health and safety related training including fire safety, infection control and manual handling. Staff told us in discussions and feedback forms that they had no concerns with the arrangements in place for ensuring health and safety.

There was a comprehensive business continuity plan in place to provide guidance for dealing with a major disruption to the service, for example an IT failure.

There were a range of clinical and non-clinical roles within the practice. The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and opportunities for development.

Staff told us that they felt there were enough staff to provide safe, high-quality care and they worked effectively as a team. There were appropriate arrangements in place for covering staff sickness, absence and vacancies and the use of temporary staff was minimal.

Staff told us they had protected learning time for them to undertake training, learning and professional development and that they had received training appropriate and relevant to their role.

We looked at the recruitment records for a sample of staff. These showed recruitment practices were conducted in line with legal requirements. All new staff underwent an induction programme and were required to undertake mandatory training within an appropriate timescale. Staff were provided with the support they needed to deliver safe care, and this included being provided with role specific training.

Infection prevention and control audits were conducted and reviewed, and actions taken were necessary and appropriate. People were protected as much as possible from the risk of infection because the premises and equipment were kept clean and hygienic. Personal protective equipment was in good supply and located appropriately around the premises. Cleaning schedules were in place, and regular infection control and cleaning audits were conducted to maintain standards. Cleaning equipment was stored safely and according to best practice.

Key staff had responsibilities around infection prevention and control, and they linked in with other infection control leads in the area. The arrangements for managing waste, sharps and clinical specimens kept people safe. Staff vaccination was maintained in line with current guidance, if relevant to their role.

The provider made sure that medicines and treatments were safe and met people’s needs. Staff managed prescription stationery appropriately and securely. Our review showed that medicines were managed and stored safely overall. The approach to medicines reflected current and relevant best practice and staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. We reviewed clinical records for patients who had been prescribed medicines which required routine monitoring and found that some patients who had been prescribed gabapentin had not undergone the required monitoring and patients with asthma had not always been followed up within the recommended timescales. The provider took immediate action to remedy these shortfalls.

Overall, there was appropriate monitoring and reviews for people with long term conditions. however, our review of patients that may have had a potential missed diagnosis of diabetes, showed a sample of patients had not been followed up appropriately. The findings were discussed with the provider, and the patients were contacted during the assessment and booked into the diabetic clinic. The provider also produced an action plan to provide assurance and reduce the potential for reoccurrence.

Staff had access to emergency medicines and equipment including oxygen and a defibrillator. These were regularly checked for stock availability and to ensure they were in date. Vaccines were stored appropriately, and regular checks were conducted to ensure safe storage and stock.