Whitemoor 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 69 (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. A representative from the Patient Participation Group (PPG) told us the provider took concerns seriously and proactively made improvements to the service. For example, the PPG were working with the practice to support people to use the NHS app. Managers encouraged staff to raise concerns when things went wrong. During clinical meetings, the team discussed and learnt from significant events and complaints. Staff told us there was an open culture, and that safety was a priority. The provider had processes for staff to report significant events, near misses and safety events. However, the analysis of significant events lacked detail. In response to this, leaders appointed a new designated lead to investigate significant events.

There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that improved care for others. There were systems in place to monitor trends in significant events and complaints, and action was taken to address them.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. The practice held regular clinical meetings, and meetings with the wider multidisciplinary team, to discuss the care of people and ensure clear communication pathways between professionals such as the district nurses and health visitors.

There were systems in place for processing information relating to new patients. 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, for example health visitors and district nurses. During our remote searches we found that alerts were not always added to the records of people living in the same household as adults and children with known safeguarding concerns. On the day of our onsite assessment, we found the service had updated their processes and action had been taken to add alerts where it was appropriate to do so.

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.

Staff could recognise a deteriorating patient and knew of the action to take. Non-clinical staff had received appropriate training to support them in this role and used flashcards to help them to identify conditions where an urgent response was required. To promote patient safety and rapid treatment responses when required, the duty GP was co-located with reception staff. This meant there was immediate clinical input for deteriorating patients or complex queries; faster triage decisions, potentially reducing delays in care; and support for receptionists if they faced challenging calls and needed reassurance or guidance. People were advised of 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 safely maintained. For example, the lift. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed. For example, fire and legionella risk assessments. 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, appraisals, clinical supervision and development. Staff told us they were supported to attend additional training specific to their role and there was protected time to complete mandatory training as identified by the service.

There was 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. There was a system of audit and clinical supervision to support non-medical prescribers. 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. Cleaning schedules were in place and followed. The practice had a designated infection, prevention and control (IPC) lead and staff had completed relevant training.

A detailed IPC audit had been completed and an action plan put in place to address any risks identified. The action plan showed who was responsible for the improvements, expected completion due dates and the status of completion. Carpets in clinical rooms and waiting rooms had been identified as an IPC risk and a rolling programme to replace them had been started. To mitigate potential risks whilst waiting for the remaining carpets to be replaced, the provider put systems in place to deep clean the carpets 6 to 12 monthly.

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.

Staff had the appropriate authorisations to administer medicines. There was an effective system for recording and acting on safety alerts such as Medicines and Healthcare products Regulatory Agency (MHRA) alerts. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. There were systems in place to monitor the prescribing of non-medical prescribers.

Staff received regular training and followed protocols to ensure they prescribed all medicines safely. Medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates of medicines and vaccines. Staff were aware of the actions to take in the event of a cold chain breach in the storage of vaccines.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued by the provider was comparable with national averages.

Medicine reviews were in place but were mostly desktop reviews without the involvement of the person. Most people prescribed high-risk medicines were appropriately monitored however a formal documented system for managing people who did not comply with monitoring was not in place. Immediately following our assessment, the provider sent us their updated medicine prescribing policy to show the new processes that had been put in place to address these concerns. They also sent to us details of the actions they had taken to address the non-compliance of a very small number of people who had failed to attend for the required medicine monitoring that we identified through our remote clinical searches.

Blank prescriptions were kept securely however, systems for tracking prescription stationery throughout the practice were not effective. Following our assessment, the provider sent us their updated policy for tracking prescription stationery throughout the practice and evidence that the required actions had been completed. The practice had clearly checked the emergency medicines and equipment as they held all of the required items and emergency medicines were in date. However, a clear audit trail to demonstrate when emergency medicines and equipment had been completed was not in place. Following our assessment the provider sent to us the very detailed checklists they had implemented to provide this audit trail.