Northgate 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

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes.

This service scored 75 (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. During staff meetings, the whole team discussed and learnt from clinical issues. Staff felt there was an open culture, and that safety was a top priority. 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. Learning from incidents and complaints resulted in changes that improved care for others. For example, delays in repeat prescriptions for vulnerable patients. A major alert was added to the patients’ records.

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.

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. Blank prescription stationery were secured; however, we found gaps in record keeping. This was reviewed and actioned immediately to ensure there was a clear audit trail.

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. Regular meetings took place to discuss those on safeguarding, vulnerable adult and children registers. During an on-site visit we reviewed vulnerable patients to ensure they were appropriately coded and safeguarding alerts were placed in both individual and household family member records.

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 action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated. All staff had completed basic life support training within the past 12 months, ensuring they were prepared to respond appropriately in emergency situations.

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

The practice premises were managed by an employee of Northgate Practice to ensure they were maintained. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed. However, we found no risk assessment was in place for corded blinds. This was reviewed and actioned by the practice immediately and a risk assessment was put in place. A Blind Safety Policy was put in place together with a monthly checklist.

The practice maintained a business continuity plan 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.

The practice employed a range of clinical and non-clinical roles within the practice to support service delivery. 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. Safe recruitment practices were followed.

Staff training was up to date and learning needs were appropriately identified and supported. Staff were working within their defined areas of competences which was supported through clinical supervision, audits and protocols.

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 manually and electronically, and all staff had completed annual appraisals. New staff participated in a structured induction programme and were required to complete core training within appropriate timeframes. Staff were supported to deliver safe care through access to relevant training and development opportunities.

The practice provided health checks for staff aged 30 and over. This supported early identification of health concerns which resulted in better staff health and promoted staff wellbeing, demonstrating a proactive approach to workforce health.

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 practice had an Infection, Prevention and Control (IPC) policy in place which was reviewed regularly.

The practice 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 were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Our remote clinical searches found there had been 1324 medication reviews completed in the previous 3-month period, with 432 of these for patients over 75 years of age.

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, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. Whilst there was a process in place to manage prescriptions, it was not always followed consistently. The practice took action to address this immediately by reviewing the process to make it more robust.

Staff followed protocols to ensure they prescribed medicines safely, and ensured people received recommended medicines reviews and monitoring. Medicines, including controlled drugs, were stored securely and safely. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. Waste medicines were recorded and disposed of appropriately, including medicines returned by patients.

Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. The provider had effective systems to manage and respond to safety alerts and medicine recalls.

Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. 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 lower than local and national averages. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.