Old Orchard Consulting Rooms

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. We found that the service had improved its processes for monitoring staff and clinician completion of required training; the documentation of recruitment checks; the assessment of environmental risks and associated actions taken; and now had a system to receive and review national patient safety alerts.

At our last assessment, we rated this key question as Requires Improvement. 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 positive culture of safety. They listened to concerns about safety and risks and investigated and reported safety events. Lessons were learnt to identify and embed good practice.

The service had a policy and system for staff to report incidents, near misses and safety events. There had been 1 incident over the previous 12 months. We reviewed this. It had been investigated with a learning outcome identified, discussed and shared with the team. We were told that any clinical issues, complaints, feedback or staff concerns would be shared and discussed with the clinicians as they happened. Staff told us there was an open culture, and that safety was a top priority. There was a system to record and investigate complaints,and when things went wrong, staff apologised and gave people support. Learning from incidents resulted in changes that improved care for others.

The service worked with people to establish and maintain safe systems of care, in which safety was managed or monitored.

The service liaised with people’s NHS general practitioners (GPs) and other health professionals or third parties (such as insurance companies) when appropriate. Test results were reviewed and acted on promptly. The service shared relevant clinical information and recommendations with the person’s NHS GP if the person consented to this. We were told that people were typically happy to share this information but, if not, clinicians would discuss the reasons with them. If the clinician considered liaison with the person’s GP to be clinically important and a person still declined to have it shared, the service would not proceed with the treatment.

The service worked with people and other organisations to safeguard people from the risk of abuse or neglect.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. The service had safeguarding policies and processes to report any safeguarding concerns with the designated lead. Staff and clinicians had now completed safeguarding training to the level appropriate to their role and this was monitored and documented.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe and supportive.

People were provided with information about relevant treatments and what these might involve before and after their consultations. People were advised on risks related to their condition and actions to take if their condition deteriorated. The service had emergency equipment for use in the event of a medical emergency, including an automated external defibrillator, which was regularly checked.

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 and equipment were maintained. Health and safety risk assessments, now including legionella and fire safety, were undertaken when due, the records kept on site, and any risks identified had been addressed. There was a business continuity plan in place which was monitored and reviewed annually or following a significant change, for example to contractor details. The clinicians had written practising privileges agreements in place with several regulated acute providers in the area and could provide assurance that these locations were also suitable for the delivery of health care to people using the service.

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 service employed administrative roles to support the clinicians. The service was able to demonstrate that the clinicians were appropriately qualified, they were listed on the relevant professional specialist register, and their professional registration was in date.

The service had not recruited staff members since our previous inspection but there was a clear recruitment and induction process which included appropriate checks in line with legislation. The service had now documented evidence that all recruitment checks for existing staff and clinicians had been completed, including clinician vaccination status

Staff received support and training relevant to their role. Leaders now monitored staff completion of mandatory training and now also requested and kept a record of the clinicians’ independent appraisal outcomes which were updated annually.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading.

The service had a designated infection prevention and control lead and all staff had had relevant training. Cleaning schedules were available and followed. Whilst the service was not used by people with acute illness or infection, risk assessments and audits were completed relating to infection prevention and control, 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.

At the time of the assessment, the clinicians were only prescribing a range of medicines specific to the care and treatment provided by the service. They did not prescribe medicines that required ongoing monitoring or controlled drugs. Clinicians and practitioners advised people on how to manage any medicines safely. People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. The service had improved the way it monitored national safety alerts to ensure any relevant guidance was implemented.

The service did not keep any medicines on the premises including for use in an emergency. They told us this was clinically appropriate because people did not attend the service with acute or urgent health conditions; no medical tests or treatments took place on the premises; and the risk of a medical emergency was minimal. This was reflected in the emergency medical protocol and associated risk assessment which outlined the steps staff must take in the event of a medical emergency.