Olive Medical Practice

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 inadequate. During this assessment, we found evidence of significant and wide-ranging improvements, including the implementation of a robust recruitment system and the development of a positive learning culture. At this assessment, the rating has changed to good.
 

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 staff treated them with compassion and understanding. 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 we spoke with felt there was an open culture and gave examples of how to report incidents and significant events. 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.
 

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, including the summarising of new patient notes. There were protocols in place for managing incoming correspondence into the patient’s medical records.

The service worked with other providers to deliver shared care and when patients moved between services. Staff we spoke with described how referrals and test results were managed in a timely way and patient records were kept up to date.
 

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 relevant to their roles. Staff training was up to date and staff we spoke with were aware of systems to escalate safeguarding concerns and were able to give examples. The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations.
 

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. Systems, processes and equipment were in place to manage and check medical emergencies, including an automated external defibrillator, oxygen and emergency medicines.

All staff were trained in basic life support. Staff could recognise a deteriorating patient and knew of action to take and how to alert and respond to emergencies. During our inspection, an emergency incident occurred and we saw staff deal with this appropriately.

Clinical and non-clinical staff had received sepsis awareness training. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.
 

At our last assessment the service had not ensured the appropriate premises risk assessments had been maintained. At this assessment we found appropriate risk assessments and maintenance records in place. The service carried out regular fire alarm testing and fire evacuations, and trained fire marshals were in place.

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 maintained. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed. There was a business continuity plan in place which was monitored and reviewed.
 

At our last assessment there were gaps in systems and processes to ensure safe recruitment of staff, which included evidence of safe recruitment checks. At this assessment, we found systems in place for safe recruitment. We looked at clinical and non-clinical recruitment files and found recruitment documentation in line with guidance. There was a system to capture the immunisation status of new staff at the point of recruitment.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together to provide safe care that met people’s individual needs.

There were a range of clinical and non-clinical roles within the practice and regular appraisals were in place. 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.
 

At the last assessment there were gaps in systems and processes to adequately assess infection prevention control. At this assessment, improvements had been made. Risk assessments and audits were completed, and actions taken to mitigate risks.

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 (IPC) lead, and all staff had relevant training appropriate to their role. Cleaning schedules were in place and followed. There was a cleaning checklist for each room, and the housekeeper ticked when an area had been cleaned. The practice manager and IPC lead performed regular checks of the premises.
 

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 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. Staff managed prescription stationery appropriately and securely. Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring.

Medicines, including controlled drugs, were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. Staff stored medical gases, such as oxygen, safely.

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. Prescribing data reviewed as part of our assessment confirmed this. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.

We carried out a series of searches on the services’ clinical systems as part of this assessment. These searches indicated that 1 patient required a blood test and 1 patient required coding and review. At the time of our inspection both had been addressed by the practice.