What is the Quality of Safety at Practice Plus Group - NHS 111 South West

Positive

"Track record on safety The service had a good safety record."

Positive

"• The service learned and shared lessons identified themes and took action to improve safety in the service."

Positive

"• All staff received uptodate safeguarding and safety training appropriate to their role."

Positive

"• There was a strong emphasis on the safety and wellbeing of all staff."

Positive

"At this inspection we found: • The service had good systems to manage risk so that safety incidents were less likely to happen."

Positive

"• The service learned from external safety events and patient safety alerts."

Positive

"• Leaders had established proper policies procedures and activities to ensure safety and assured themselves that they were operating as intended."

Positive

"• The provider conducted safety risk assessments."

Positive

"It had safety policies including Control of Substances Hazardous to Health and Health & Safety policies which were regularly reviewed and communicated to staff."

Positive

"Staff received safety information from the provider as part of their induction and refresher training."

Positive

"• There were comprehensive risk assessments in relation to safety issues."

Positive

"• There was a system for receiving and acting on safety alerts."

Positive

"• The service had a system in place that alerted staff to any specific safety or clinical need of a person using the service."

Neutral

"This helped it to understand risks and gave a clear accurate and current picture that led to safety improvements."

Positive

"The medical lead had made suggestions to improve safety to NHS Pathways including changes to questions in respect of headaches in order to improve the identification of people with early signs of meningitis."

Positive

"Systems were in place for notifiable safety incidents and key staff ensured this information was shared with staff to ensure appropriate action was taken."

Positive

"Overview of safety systems and processes The service had clearly defined and embedded systems processes and practices in place to keep people who used the service safe and safeguarded from abuse which included: • Arrangements were in place to safeguard children and vulnerable adults from abuse."

Positive

"This covered such topics as information governance health and safety NHS Pathways training safeguarding call control mental health awareness basic life support performance and quality assurance processes communication requirements and specific procedures relating to their place of work."

Positive

"The medical lead had made suggestions to improve safety including suggestions to improve the identification of early sepsis."

Positive

"Information about safety was valued and used to promote learning and improvement."

Positive

"Monitoring safety and responding to risk • Risks to people using the service were assessed and well managed."

Positive

"The service had a system in place that alerted staff to any specific safety or clinical needs of a patient this included special patient notes and patient specific care plans."

Positive

"Our key findings were as follows: • There were systems in place to help ensure patient safety through learning from incidents and complaints about the service."

Positive

"Examples of learning from significant events included ‘hot topic’ guidance which was cascaded to staff and updates in a safety bulletin."

Positive

"• We reviewed safety records incident reports patient safety alerts and minutes of meetings where these were discussed."

Positive

"• Staff were alerted through their computer system to people with identified specific clinical needs and special notes or any safety issues relating to a patient."

Positive

"Two examples we were given included clinical advisors supporting new health advisors after a difficult child safety call and a call involving an injury to an infant."

Positive

"• Staff were provided with a safe environment in which to work risk assessments and actions required had been taken to ensure the safety of the premises."

Positive

"Shift start times and lengths could be adjusted and breaks were planned to times of predicted lower demand within health and safety guidance on safe working."

Positive

"Externally they reported any complaint learning and themes monthly to the Integrated Quality and Performance Management Board which consisted of Commissioners contract managers and patient safety leads from each of the CCG’s."

Positive

"The research had involved analysis into a large number of calls received by the service root cause analysis of any issues national patient safety investigations reviewing professional responsibilities and any system factors which impacted on the patient experience."

Positive

"This along with the integrated clinical governance framework provided an overview with direct links into action plans with risk ratings for several areas such as audit clinical governance human resources health and safety local operating procedures operational processes performance planning and training."

Neutral

"We saw evidence that all staff also completed mandatory training elearning modules such as equality and diversity and work station health and safety awareness before they started operationally within their new role."

Positive

"We observed staff taking steps to protect patients from abuse neglect harassment discrimination and breaches of their dignity and respect."

Positive

"Overview of safety systems and processes The service had clearly defined and embedded systems processes and practices in place to keep people who used the service safe and safeguarded from abuse which included: • Arrangements were in place to safeguard children and vulnerable adults from abuse."

Positive

"Our findings Kindness respect and compassion Staff treated patients with kindness respect and compassion."

Positive

"• Staff involved and treated people with compassion kindness dignity and respect."

Positive

"We observed staff taking steps to protect patients from abuse neglect harassment discrimination and breaches of their dignity and respect."

Positive

"Privacy and dignity Are services caring?"

Positive

"• Staff were clear on their roles and accountabilities including in respect of safeguarding."

Positive

"Our findings Kindness dignity respect and compassion We observed members of staff were courteous and very helpful to people calling the service and treated them with dignity and respect."

Positive

"• People using the service were treated with compassion dignity and respect and they were involved in decisions about their care and treatment."

Positive

"The medical lead had made suggestions to improve safety to NHS Pathways including changes to questions in respect of headaches in order to improve the identification of people with early signs of meningitis."

Positive

"We saw that call was dealt with effectively and efficiently with due compassion patience and respect for both parties involved."

Positive

"• We saw staff treat people with kindness and respect and maintained the caller’s confidentiality."

Positive

"In the latest staff survey the results indicated that respondents felt they were treated with fairness and respect by the management."

Positive

"We observed staff treated people with compassion and responded appropriately to their feedback."

Positive

"• The service actively promoted equality and diversity."

Neutral

"• Staff had received equality and diversity training."

Positive

"Tackling inequity and promoting equality • The service engaged with people who were vulnerable and took action to remove barriers when people found it hard to access or use services."

Neutral

"We saw evidence that all staff also completed mandatory training elearning modules such as equality and diversity and work station health and safety awareness before they started operationally within their new role."

Positive

"• The complaint policy and procedures were in line with recognised guidance."

Positive

"• Information about how to make a complaint or raise concerns was available and it was easy to do."

Positive

"They also displayed complaint learning on the staff electronic display board in the break area."

Positive

"We saw examples of the communication throughout the complaint process to involve and update the complainant about any action being undertaken."

Positive

"Externally they reported any complaint learning and themes monthly to the Integrated Quality and Performance Management Board which consisted of Commissioners contract managers and patient safety leads from each of the CCG’s."

Positive

"Lessons were learnt from concerns and complaints and action was taken to as a result to improve the quality of the service for example we tracked one complaint about staff attitude and noted the clear process of investigation."

Positive

"• Structures processes and systems to support good governance and management were clearly set out understood and effective."

Positive

"Governance arrangements There were clear responsibilities roles and systems of accountability to support good governance and management."

Positive

"They demonstrated joint working and shared governance with partner organisations stakeholders around significant risks such as serious incidents and implemented changes to improve the quality of care and patient experience such as DCRASH a communication handover tool."

Positive

"The governance and management of partnerships joint working arrangements and shared services promoted interactive and coordinated personcentred care."

Positive

"• We saw a strong focus on continuous learning quality improvement and risk management from complaints and incidents and performance management which included joint working and shared governance with partner organisations."

Neutral

"Learning was used to make improvements to the service and we saw examples of joint governance and integration with other providers as a result."

Neutral

"Other activities such as quizzes with prizes based on new and updated governance processes was in place."

Positive

"They regularly met with the commissioning groups and other health and social care providers to try to ensure they were working together to respond to local health inequalities and ensured services were accountable and supported by strong governance processes."

Positive

"This covered such topics as information governance health and safety NHS Pathways training safeguarding call control mental health awareness basic life support performance and quality assurance processes communication requirements and specific procedures relating to their place of work."

Positive

"• There was an overarching governance framework which supported the delivery of the strategy and service quality."

Positive

"The service had an overarching governance framework which supported the delivery of care."

Positive

"These were supported and monitored by governance structures and arrangements."

Positive

"We saw board minutes lessons learnt and governance bulletins which supported this."

Positive

"Complaints concerns health care professional feedback significant events and noncompliant call audits were reported on in a monthly clinical governance report."

Positive

"The clinical governance team reviewed the complaints received to see if there were any themes that could be identified and any areas of learning which were shared within the staff team and commissioning organisations."

Positive

"This along with the integrated clinical governance framework provided an overview with direct links into action plans with risk ratings for several areas such as audit clinical governance human resources health and safety local operating procedures operational processes performance planning and training."

Neutral

"Regular governance meetings were held."

Neutral

"• Spoke with a range of clinical and non clinical staff such as; health advisors clinicians team managers clinical supervisors clinical and nonclinical coaches senior managers a lead trainer which included NHS Pathways training and the clinical governance team."

Neutral

"Locally clinical governance procedures and reporting pathways were established and regular clinical governance meetings were undertaken by the senior management team commissioners and national leads."

Neutral

"• Clinical governance procedures and reporting pathways were well established and regular clinical governance meetings were undertaken at provider service commissioner and national level."

Neutral

"A monthly clinical governance report was produced to summarise the ongoing work across the region and included statistical data relating to call activities audits and trends."

Neutral

"They understood the line management arrangements as well as the clinical governance arrangements which were in place."

Positive

"The service demonstrated plans were consistently implemented and had a positive impact on quality and sustainability of services."

Positive

"• Quality and sustainability were discussed in relevant meetings where all staff had sufficient access to information."

Positive

"• We saw a strong focus on continuous learning quality improvement and risk management from complaints and incidents and performance management which included joint working and shared governance with partner organisations."

Positive

"Monitoring care and treatment The service had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided."

Positive

"The leadership team had developed a continuous quality improvement model of audit management for the service which monitored all aspects of the service."

Positive

"For example the service used innovative ways to improve care where possible for example the clinical bridge model supported by a risk stratification tool and an audit process and the development of tools to improve quality of care provided."

Positive

"Audits had a positive impact on quality of care and outcomes for patients."

Positive

"• Clinical audit had a positive impact on quality of care and outcomes for patients."

Positive

"They demonstrated joint working and shared governance with partner organisations stakeholders around significant risks such as serious incidents and implemented changes to improve the quality of care and patient experience such as DCRASH a communication handover tool."

Positive

"This report describes our judgement of the quality of care at this service."

Positive

"This helped managers to focus on understanding how leadership behaviours affected the culture and climate and how staff affected the experiences of people who used the service and the quality of care provided."

Positive

"This report describes our judgement of the quality of care at this service."

Positive

"This helped managers to focus on understanding how leadership behaviours affected the culture and climate and how staff affected the experiences of people who used the service and the quality of care provided."

Positive

"This included adapting auditing tools for quality assurance purposes to ensure learning was embedded and implementation of communication tools and apps."

Positive

"These were shared using the quality monitoring recording and reporting processes internally through the quality assurance meetings and externally through the Integrated Quality and Performance Management Board."

Positive

"This covered such topics as information governance health and safety NHS Pathways training safeguarding call control mental health awareness basic life support performance and quality assurance processes communication requirements and specific procedures relating to their place of work."

Positive

"They reported learning and themes via the internal quality assurance meetings and their internal National Quality Assurance Group."

Positive

"We saw that the provider had shared the findings and any learning identified with staff and it was recorded as part of the quality assurance process."

Positive

"Once training had been completed both health advisors and clinicians were subject to a structured quality assurance programme."

Positive

"These were shared using the quality monitoring recording and reporting processes internally through the quality assurance meetings and externally through the Integrated Quality and Performance Management Board."