What is the Quality of Safety at Bowburn Medical Centre

Positive

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

Positive

"Privacy and dignity The practice respected and promoted patients’ privacy and dignity."

Positive

"• Staff recognised the importance of patients’ dignity and respect."

Positive

"This was because the arrangements in respect of recording investigating and learning from complaints needed improving and the results from the National GP Patient Survey in relation to access were below average."

Positive

"Staff took steps to protect patients from abuse neglect harassment discrimination and breaches of their dignity and respect."

Positive

"• However patients we spoke with said they were treated with compassion dignity and respect and they felt involved in decisions about their care and treatment."

Positive

"Patients told us they were satisfied with the care provided by the practice and said their dignity and privacy was respected."

Positive

"They also told us they were treated with respect and dignity at all times and they found the premises to be clean and tidy."

Positive

"• The vast majority of patients said they were treated with compassion dignity and respect."

Positive

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

Positive

"• Curtains were provided in consulting rooms so that patients’ privacy and dignity was maintained during examinations investigations and treatments."

Positive

"• We found improvements in the overall governance arrangements improved care and treatment for patients and better safety systems and processes • There were clear systems to keep patients safe and safeguarded from abuse."

Positive

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

Positive

"Governance arrangements The practice did not have an overarching governance framework which supported the delivery of good quality care."

Positive

"• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards."

Positive

"Establish effective systems and processes to ensure good governance in accordance with the fundamental standards."

Positive

"• There was a lack of good governance and the number of concerns we identified during the inspection reflected this."

Positive

"The lack of good governance had contributed to all of these issues."

Neutral

"For example recent training on infection control information governance and the Mental Capacity Act had not been provided for all relevant staff."

Positive

"Good As part of our inspection process we also look at the quality of care for specific population groups."

Positive

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

Positive

"This recognises the significant improvements made to the quality of care provided by the service."

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

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

Positive

"Privacy and dignity The practice respected and promoted patients’ privacy and dignity."

Positive

"Patients 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 so that patients’ privacy and dignity was maintained during examinations investigations and treatments."

Positive

"• We found improvements in the overall governance arrangements improved care and treatment for patients and better safety systems and processes • There were clear systems to keep patients safe and safeguarded from abuse."

Positive

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

Positive

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

Positive

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

Positive

"The arrangements for dealing with safety alerts were ineffective safety alerts inform the practice of problems with equipment or medicines or give guidance on clinical practice."

Positive

"The practice learned from external safety events as well as patient and medicine safety alerts."

Positive

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

Positive

"Staff received safety information for the practice as part of their induction and refresher training."

Positive

"Track record on safety When we previously inspected the practice we identified a number of concerns in relation to how the practice monitored risks."

Positive

"We also found: • There were comprehensive risk assessments in relation to safety issues."

Neutral

"• The practice conducted safety risk assessments and had a number of safety policies which were regularly reviewed and communicated to staff."

Neutral

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

Positive

"• Implement a system to document significant events and patient safety alerts to ensure they are all recorded and reviewed as necessary."

Positive

"Implement a system to document significant events and patient safety alerts to ensure they are all recorded and reviewed as necessary."

Positive

"• A new system for reviewing patient safety alerts had been implemented and three members of staff had been given responsibility for taking action two clinical and one administrative."

Positive

"Weekly checks were carried out to identify any new safety alerts."

Positive

"There were no systems or processes that enabled the registered person to assess monitor and mitigate the risks relating to the health safety and welfare of service users and others who may be at risk."

Positive

"The arrangements for managing medicines including emergency drugs and vaccinations in the practice minimised risks to patient safety including obtaining prescribing recording handling storing security and disposal."

Positive

"Overview of safety systems and processes The practice had some systems processes and practices in place to minimise risks to patient safety but these were not always effective: • Arrangements for safeguarding reflected relevant legislation and local requirements."

Positive

"• There was no recorded evidence to show that patient safety alerts had been actioned and relevant searches carried out to determine if any patients were affected."

Positive

"• We discussed the process for dealing with safety alerts with staff."

Positive

"Monitoring risks to patients There were some procedures for assessing monitoring and managing risks to patient and staff safety but these were not always effectively followed."

Positive

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

Positive

"• Staff received some training that included: safeguarding basic life support and fire safety awareness."

Positive

"• Some of the clinical staff were unaware of recent patient safety alerts and there was no recorded evidence to show that alerts were discussed at appropriate meetings to ensure all relevant staff were aware of any necessary actions."

Neutral

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

Positive

"Staff took steps to protect patients from abuse neglect harassment discrimination and breaches of their dignity and respect."

Positive

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

Positive

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

Positive

"• One of the practice nurse’s was the infection control clinical lead; they liaised with the local infection prevention teams to keep up to date with best practice."

Positive

"• The practice was clean and hygienic and some infection control arrangements were in place."

Positive

"• We also identified issues with infection control and support given to staff through training and appraisals access to appointments and patient satisfaction."

Neutral

"There was an infection control protocol in place but staff had not received up to date training."

Neutral

"An infection control audit had recently been undertaken and an action plan to address any improvements identified was in place."

Neutral

"For example recent training on infection control information governance and the Mental Capacity Act had not been provided for all relevant staff."

Neutral

"There were gaps in training including infection control and information governance."

Positive

"• The practice actively promoted equality and diversity."

Neutral

"Staff had received equality and diversity training."

Positive

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

Positive

"The NHS complaints policy states that the response ‘should also include details of your right to take your complaint to the relevant ombudsman’."

Positive

"For example following a complaint about a delay in taking action from a hospital discharge letter staff received further training."

Positive

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

Positive

"• The practice was involved in quality improvement activity."

Positive

"Staff were aware of this and were considering how best to approach quality improvement over the coming months: • There had been one clinical audit over the past two years where the improvements made were implemented and monitored."

Positive

"• There was evidence of some quality improvement including clinical audit although this was at an early stage which we were informed was due to workload pressures."

Positive

"There was evidence of some quality improvement including clinical audit although this was at an early stage which we were informed was due to workload pressures."

Positive

"Patients were complimentary about the practice the staff who worked there and the quality of service and care provided."