HMC Health Feltham

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 using the old methodology in 2021, we rated this key question as good. At this assessment using the assessment framework, the rating remains the same. We were assured patient safety and clinical care were not compromised.

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. The staff and leadership at this location listened to concerns about safety, investigated and reported safety events. Complaints from patients were responded to in a clear and honest approach and documented transparently. Lessons were learnt to consistently identify and embed good practice.

However, the patient complaints process needed to be clearer for patients to use effectively. Learning outcomes were discussed at both clinical and administrative meetings, however details of action plans were not always clear. For example, a recent incident before our visit where the blood test was done for a wrong patient (the learning was to ensure date of birth for patients was used to identify patients, but this was not documented).

The staff informed us that they were encouraged to raise concerns. Lessons learned from complaints, significant events were shared with staff during staff meetings and minutes of such meetings shared with all staff electronically.

The service worked with people and healthcare partners to ensure and maintain safe systems of care, in which safety was managed and monitored. The location ensured that there was continuity of care and patient records were updated to reflect changing needs. There were systems in place for processing information relating to new patients.

The service worked with other care providers in the community 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 rights 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 and the safeguarding leads for adult and children were identified by staff.

All staff were trained on safeguarding procedures. The practice had a list of vulnerable people, acted on concerns and worked in partnership with other organisations such as the local safeguarding board.

The service worked with people to understand and manage risks by thinking of the patient individually and holistically. They provided care to meet people's needs which 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 actions to take. Patients were advised on risks related to their conditions 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. There were contracts in place to ensure the premises were maintained in conjunction with NHS Property who owns the premises. There was a business continuity plan in place, however, it needed to be reviewed as it was last reviewed and updated in October 2018 and the list of staff to be contacted was no longer current. The health and safety policy of the practice was last reviewed in April 2018. A fire policy was not in place; however, the staff had completed fire safety training and the certificate of test and inspection (fire detection and alarm systems) seen during the site visit. Non-clinical areas were not open to the public and locked to prevent patient access. Fire drill was completed every 6 months. Prescription stationery was locked securely in a cupboard with serial numbers of stationery logged and kept in clear plastic folders.

The service made sure there were enough qualified, skilled and experienced staff, who received support, supervision/ appraisal and development opportunities. The staff worked well together to provide safe care that met people’s individual needs. The practice had a range of clinical and non-clinical roles. We found staff training was up to date.

Learning needs and development of staff were managed well with staff working within their area of competencies. Staff were recruited safely with staff records seen during the site visit.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies or partners. The practice had a designated Infection Prevention and Control lead (IPC) lead, and all staff had completed relevant training. Risk assessments and audits were completed and action taken to mitigate risks. The practice had an appropriate policy in place which all staff followed. Staff immunisation records were seen.

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 involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People knew what to do if their condition did not improve or they experienced any unexpected symptoms. Staff received regular training. Staff managed prescription stationery appropriately. Staff regularly checked the stock levels and expiry dates for all medicines including emergency medicines, vaccines and controlled drugs.

Checks of the emergency medicine and equipment completed by the assessment team showed that the stethoscope was missing from the emergency medicine and resuscitation bag, and the practice informed the assessment team that the stethoscope was borrowed by a GP earlier which did not indicate that the bag was tamper proof and required emergency equipment was readily available in an emergency in accordance with recommended guidance (Resuscitation Council UK guidance). The practice was signposted to the relevant recommended guidance and have completed a risk assessment for the checks after they followed up on the guidance with the Resuscitation Council UK. Risk assessment was shared with us, however, it was not signed or dated.

We identified a need to ensure female patients on valproates were informed of the side effects on their reproductive health to make an informed choice on their decisions.

Staff stored medical gases safely and completed required safety risks 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. Staff followed protocols to complete recommended reviews and monitoring were done with the patients. The prescribing data reviewed as part of our assessment showed that the practice prescribed antimicrobials at a level that is lower than or in line with local and national averages. Clinical audits of prescribing were conducted which showed the drive to improve care and treatment of the patients.