What is the Quality of Safety at High Street Surgery

Positive

"The clinical pharmacists role was extensive and incorporated improvement in patient compliance and understanding of their medication such as improving medicines safety providing support to our administration team for medicines queries and liaising with local pharmacies and the medicines management team at the CCG."

Positive

"• The practice had a variety of other risk assessments to monitor safety of the premises such as control of substances hazardous to health and infection control and legionella Legionella is a term for a particular bacterium which can contaminate water systems in buildings."

Positive

"• We saw evidence that lessons were shared and action was taken to improve safety in the practice."

Positive

"• The arrangements for managing medicines including emergency medicines and vaccines in the practice did not always minimise risks to patient safety including obtaining prescribing recording handling storing security and disposal."

Positive

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

Positive

"The arrangements for managing medicines including emergency medicines and vaccines in the practice did not always minimise risks to patient safety including obtaining prescribing recording handling storing security and disposal."

Positive

"• Medicine safety alerts alerts that are issued nationally regarding faulty products were sent to dispensary staff and dealt with appropriately."

Positive

"Our key findings were as follows: • There was an open and transparent approach to safety and a system for reporting and recording significant events."

Positive

"Overview of safety systems and processes The practice systems processes were not always implemented effectively to minimise risks to patient safety."

Positive

"For example health and safety risks including fire safety and legionella monitoring."

Positive

"• There was a health and safety policy available."

Positive

"• Records showed most staff received training that included: safeguarding fire safety awareness basic life support and information governance."

Positive

"For example one member of staff was not up to date with fire safety training two members of staff were not up to date with infection prevention and control training and members of the clinical team including locum GP s could not evidence that they had completed safeguarding training."

Positive

"The practice could not demonstrate that locum GPs employed directly by the practice were up to date in training such as fire safety and safeguarding."

Positive

"The practice was unable to demonstrate they had effective procedures to manage quality improvements or governance systems relating to the monitoring of risk to patients for infection prevention and control fire safety and legionella management."

Neutral

"This covered such topics as safeguarding infection prevention and control fire safety health and safety and confidentiality."

Positive

"Requires improvement ––– People with long term conditions The provider was rated as requires improvement for safety and responsive."

Positive

"Requires improvement ––– Families children and young people The provider was rated as requires improvement for safety and responsive."

Positive

"Requires improvement ––– Working age people including those recently retired and students The provider was rated as requires improvement for safety and responsive."

Positive

"Older people The provider was rated as requires improvement for safety and responsive."

Positive

"Requires improvement ––– People experiencing poor mental health including people with dementia The provider was rated as requires improvement for safety and responsive."

Positive

"The practice also had a variety of other risk assessments to monitor safety of the premises such as control of substances hazardous to health infection control and legionella."

Positive

"People whose circumstances may make them vulnerable The provider was rated as requires improvement for safety and responsive."

Positive

"Overview of safety systems and processes The practice had clearly defined and embedded systems processes and practices to keep people safe which included: • There were arrangementsto safeguard adults and children from abuse that reflected relevant legislation and local requirements and policies were accessible to all staff."

Positive

"There was a health and safety policy available with a poster in the reception office."

Neutral

"• The practice had an induction programme for newly appointed nonclinical members of staff that covered such topics as safeguarding fire safety health and safety and confidentiality."

Positive

"• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns."

Positive

"Staff knew how to recognise signs of abuse in vulnerable adults and children."

Positive

"Overview of safety systems and processes The practice had clearly defined and embedded systems processes and practices to keep people safe which included: • There were arrangementsto safeguard adults and children from abuse that reflected relevant legislation and local requirements and policies were accessible to all staff."

Positive

"• The practice had a variety of other risk assessments to monitor safety of the premises such as control of substances hazardous to health and infection control and legionella Legionella is a term for a particular bacterium which can contaminate water systems in buildings."

Positive

"The practice also had a variety of other risk assessments to monitor safety of the premises such as control of substances hazardous to health infection control and legionella."

Positive

"The practice nurse was the infection control clinical lead who liaised with the local infection prevention teams to keep up to date with best practice."

Neutral

"There was an infection control protocol and staff had received up to date training."

Neutral

"Annual infection control audits were undertaken and we saw evidence that action was taken to address any required improvements identified as a result."

Neutral

"For example: • Patients receiving end of life care carers those at risk of developing a longterm condition and those requiring advice on their diet smoking and alcohol cessation."

Positive

"Ensure staff read understand and sign standard operating procedures relevant to their role and errors and near misses are consistently reported and discussions take place for staff to learn lessons to reduce further risk."

Positive

"• Conversations between receptionists and patients could be overheard in the reception area and there was signage requesting waiting patients stand back from the reception desk and respect confidentiality."

Positive

"Ensure staff read understand and sign standard operating procedures relevant to their role."

Positive

"Kindness dignity respect and compassion During our inspection we observed that members of staff were courteous and very helpful to patients and treated them with dignity and respect."

Positive

"• Survey information we reviewed showed that patients said they were treated with compassion dignity and respect and they were involved in decisions about their care and treatment."

Positive

"• We saw staff treated patients with kindness and respect and maintained patient and information confidentiality."

Positive

"We spoke with five patients including four members of the patient participation group PPG who told us their dignity privacy and preferences were always considered and respected."

Positive

"• Curtains were provided in consulting rooms to help maintain patients’ privacy and dignity during examinations investigations and treatments."

Positive

"• Conversations between receptionists and patients could be overheard in the reception area and there was signage requesting waiting patients stand back from the reception desk and respect confidentiality."

Positive

"Patients said they felt the practice offered an excellent service and staff were helpful caring and treated them with dignity and respect."

Positive

"Results from the national GP patient survey showed patients were happy with how they were treated and that this was with compassion dignity and respect."

Positive

"• Patients said they were treated with compassion dignity and respect and they were involved in their care and decisions about their treatment."

Positive

"Patients said they were treated with compassion dignity and respect and they were involved in decisions about their care and treatment."

Positive

"We spoke with two members of the patient participation group PPG who told us they were satisfied with the care provided by the practice and said their dignity and privacy was respected."

Positive

"We also saw that staff treated patients with kindness and respect and maintained confidentiality."

Positive

"Patients told us they were treated with dignity and respect and involved in making decisions about their treatment options."

Positive

"• Curtains were provided in consulting rooms to maintain patients’ privacy and dignity during examinations investigations and treatments."

Positive

"• The practice had a range of governance documents to support the delivery of the strategy and good quality care."

Positive

"Governance arrangements The practice had a range of governance documents to support the delivery of the strategy and good quality care."

Positive

"However we found governance arrangements were not always effectively implemented: • There was a clear leadership structure and staff felt supported by management."

Positive

"However we found that governance arrangements were not always effectively implemented: • There was a clear staffing structure and that staff were aware of their own roles and responsibilities."

Positive

"• Revise risk management and governance documents to ensure that all risks to patients staff and visitors are identified and managing in an effective and timely manner."

Positive

"The practice was unable to demonstrate they had effective procedures to manage quality improvements or governance systems relating to the monitoring of risk to patients for infection prevention and control fire safety and legionella management."

Positive

"Governance arrangements The practice had an overarching governance framework which supported the delivery of the strategy and good quality care."

Neutral

"The practice had a number of policies and procedures to govern activity and held regular governance meetings."

Neutral

"• Staff received training that included: safeguarding fire procedures basic life support and information governance awareness."

Positive

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

Positive

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

Positive

"We spoke with five patients including four members of the patient participation group PPG who told us their dignity privacy and preferences were always considered and respected."

Positive

"• Curtains were provided in consulting rooms to help maintain patients’ privacy and dignity during examinations investigations and treatments."

Positive

"We spoke with two members of the patient participation group PPG who told us they were satisfied with the care provided by the practice and said their dignity and privacy was respected."

Positive

"• Curtains were provided in consulting rooms to maintain patients’ privacy and dignity during examinations investigations and treatments."

Positive

"There was some evidence of quality improvement including clinical audit."

Positive

"Clinical audits were carried out to demonstrate quality improvement and all relevant staff were involved to improve care treatment and patient outcomes."