The Practice St Albans

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 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. We reviewed incidents and complaints reported in the six months prior to our assessment. All staff were encouraged to record these on a central system, where they were reviewed by managers locally and at a regional level to ensure risks were graded correctly and acted on. Incidents were further reviewed by a governance team who would assess if the incidents required reporting on the Learn from Patient Safety Events (LFPSE) service for wider learning across the NHS. Staff understood duty of candour; patients received contact and apologies where mistakes had been made.

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. Learning from incidents and complaints resulted in changes that improved care for others. Managers acknowledged they had experienced a high turnover of staff since our last inspection and there had been changes in the management team at the service in the last year. They had responded to this by increasing training sessions involving both clinical and non-clinical staff to promote a cohesive approach with the new staff. Whilst some vacancies remained, staff could cover between the two practice sites. Staff were encouraged to speak up; freedom to speak up posters were available within the practice.

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.

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.

A triage hub for all 12 GP practices operated by the provider in their local region was hosted at the Nirmala branch site. Clinicians supported administration staff to signpost patients and respond to people’s immediate needs effectively. Patients from The Practice St Albans benefited from the close proximity of additional clinical staff who could see and assess patients who requested to be seen immediately,

Emergency equipment was available and maintained. Following a serious untoward event, the provider implemented additional batteries for their defibrillators at each site, to ensure their services continued to operate safely if a defibrillator had been used during an emergency. Defibrillator pads were also changed to ensure the types stocked were suitable for all people. Emergency medicines held on site were in date and there was a system for monitoring expiry dates on a weekly basis.

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. For example, an incident in which a patient deteriorated in the waiting room prompted team learning on recognising people who may need urgent attention and how staff would contact emergency services through the practice mobile phone to ensure ongoing contact with them.

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

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 a designated infection, prevention and control lead (IPC) 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. We reviewed audits conducted by the provider on a regular basis, which incorporated actions identified by external audits, showing how actions were monitored and implemented. A senior nurse manager maintained oversight of the IPC activities and met with all nurses regularly for ongoing support and development.

We reviewed two clinical rooms as part our inspection; these were clean, tidy, equipped and maintained in line with recommended guidelines. We found medicines kept in rooms were appropriate and managed safely. Cold chain procedures were followed for medicines which required refrigeration such as vaccines.

The GP surgery achieved 98% compliance in an internal health and safety audit conducted by the provider.

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