Tessa Jowell GP 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 people were protected from abuse and avoidable harm.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good.

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. Staff managed medicines well and involved people in planning any changes.

This service scored 72 (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.

Staff told us they felt supported to raise concerns and were encouraged to report incidents. Staff told us incidents were used as potential learning events and not to place blame on individuals. During staff meetings, the whole team discussed and learnt from clinical issues. 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. We saw evidence of detailed analysis of significant events which included the people involved in the event. Learning was shared with practice staff as well as with other locations operated by this provider.

The service worked with patients 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 patients moved between different services.

There were systems in place for processing information relating to new patients. The service worked with other providers to deliver shared care and when patients moved between services. Referrals and test results were managed in a timely way.

The service worked with patients 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 trained in safeguarding procedures. The practice maintained a list of vulnerable patients and acted on concerns working in partnership with other organisations. We reviewed the records of 4 children on the safeguarding register. We found that for 2 of these patients there were alerts on the child’s record to indicate they were on the safeguarding register, as well as an alert on the household members of the child. For the other 2 patients, we saw alerts only on the child’s record. By placing alerts on the records of the adults living with a child on the safeguarding register, clinicians are made aware of a vulnerable child living in the same household and can risk assess appropriately. Following our feedback to the provider we were told alerts had been added to the household members of these children.

The service worked with patients to understand and manage risks by thinking holistically. They provided care to meet patients’ needs that was safe, supportive and enabled people to do the things that mattered to them.

Emergency equipment was available and maintained. We found the provider did not store a paediatric pulse oximeter with the emergency equipment. However, there were paediatric pulse oximeters stored in clinical rooms. Following our feedback, the provider told us a paediatric pulse oximeter had been added to the emergency equipment. 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

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.

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 patients’ individual needs.

There were a range of clinical and non-clinical roles within the practice. 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. Safe recruitment practices were followed.

Some staff members told us they would like to see an increase in the number of clinical staff to provide services to patients. At the time of our inspection, the provider was actively recruiting for a GP (to cover approximately 6 sessions), an advanced nurse practitioner (to cover approximately 2 session) and a practice nurse (to cover approximately 6.5 sessions). These sessions were currently being provided by locum staff. The provider had a system in place to ensure the number of appointments available aligned with patient demand.

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 had relevant training. All staff we spoke to were able to name the practice’s IPC lead. Risk assessments and audits were completed, and actions taken to mitigate risks.

The service made sure that medicines and treatments were safe and met patients’ needs, capacities and preferences.

Staff followed protocols to ensure they prescribed all medicines safely, and ensured patients received all recommended medicines reviews and monitoring. Staff followed established processes to ensure patients prescribed medicines with specific risks received recommended monitoring. We conducted clinical searches on the practice’s clinical records system. We found that most patients had received appropriate monitoring for the medicines they were prescribed. In cases where monitoring had not been carried out, we saw there had been a number of attempts to encourage patients to attend for monitoring tests using different methods of communication.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. We saw evidence in patient records that, where appropriate, patients had been informed of the risk of their prescribed medicines.

Staff involved patients in reviews of their medicines and helped them understand how to manage their medicines safely. Patients 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. Medicines were stored securely and at safe temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our inspection confirmed this. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.