The Orchard 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 staff protected people from avoidable harm and made sure care was delivered from environments that were clean and well maintained. 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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

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

The practice had contracts to ensure the premises was maintained. Staff and leaders completed health and safety risk assessments and undertook audits to ensure they had identified and addressed all risks. The practice had a business continuity plan which was regularly reviewed and outlined how the practice should continue to operate in the event of a disruption.

During our site visit, we discovered that signage to alert people to the location of oxygen cylinders was absent. This was, however, rectified immediately to comply with health and safety guidelines.

The practice did not always make sure staff were recruited safely or trained appropriately to ensure they were able to deliver safe care. However, staff received effective support, supervision and development and worked together well to provide care that met patient’s individual needs.

Mandatory training schedules were in place for staff groups but were not always being followed, and we found gaps in training records during our assessment. For example, 3 members of staff were overdue training for fire safety and 3 were overdue training in manual handling.

The practice had not always followed safe recruitment procedures when employing staff, in line with national legislation. We reviewed the recruitment records for 3 recently employed staff and found gaps in all their records. Processes for retaining photographic ID documents, and for seeking criminal records checks, were not effective, and needed improvement to keep people safe.

Since the assessment, the practice has provided information about how they plan to address gaps in staff training to comply with their own mandatory training schedules. They have also provided assurance around recruitment processes to ensure records are kept in line with current guidance.

The practice employed a range of clinical and non-clinical roles, which included GPs, nurses, paramedics and pharmacists. Regular supervision and yearly appraisals were established for all staff.

The practice did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

The practice had cleaning schedules available, which outlined how staff should clean the building and its equipment. During our onsite visit, the premises and a sample of equipment reviewed was noted to be visibly clean and we observed completed records for cleaning of clinical rooms by staff after each use. However, domestic cleaning records we reviewed were incomplete. We also found that these records had not been audited for completeness, to assure compliance with infection prevention and control (IPC) guidance.

Records held by the practice did not contain evidence that all staff were up to date with relevant immunisations, as detailed in national guidance, to prevent the spread of infection. We found gaps in the records of all 3 staff files we reviewed. For example, we found that records for 1 clinician did not contain evidence of immunisation for tetanus, diphtheria, polio or varicella. In response to this concern, the practice have provided assurance about action they are taking to strengthen their processes, and plan to audit the immunisation status of all staff to ensure compliance with recommended immunisations.

The IPC lead conducted regular risk assessments and audits to ensure compliance and took action where necessary to mitigate any identified risks. Most staff were up to date with relevant training in infection prevention and control.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.