What is the Quality of Safety at Hatton Medical Practice

Positive

"The practice was rated as requires improvement for providing safe services and we identified action the provider must and should take to improve the quality and safety of services provided."

Positive

"For example health and safety fire risk and Legionella risk assessments."

Positive

"The practice had systems for being aware of notifiable safety incidents and sharing the information with staff and ensuring appropriate action was taken."

Positive

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

Positive

"Our key findings were as follows: • There was an open and transparent approach to safety and a system in place for reporting and recording significant events although only brief details were recorded and agreed actions were not documented in the minutes of full practice meetings when discussing lessons learned."

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 were intended to minimise risks to patient safety including obtaining prescribing recording handling storing security and disposal."

Positive

"This included support training for all staff on communicating with patients about notifiable safety incidents."

Positive

"Overview of safety systems and processes The practice had clearly defined and embedded systems processes and practices in place to minimise risks to patient safety."

Positive

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

Positive

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

Neutral

"• The practice had a variety of other risk assessments to monitor safety of the premises such as control of Are services safe?"

Neutral

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

Positive

"There were appropriate systems for managing and disseminating patient safety alerts and guidance issued by the National Institute for Health and Care Excellence NICE."

Positive

"• Ensure gaps in staff training in infection control and fire safety are addressed and evidence of all training completed is documented in staff records; and arrange for outstanding annual appraisals to be conducted for staff due one."

Positive

"Lessons were shared to make sure action was taken to improve safety in the practice."

Positive

"We were shown the staff handbook that was available to all staff which included sections on work standards sickness on equality harassment and health and safety at work."

Positive

"For example there was no documentary evidence that all apart from two staff had undertaken update training since fire safety training during their induction and no details were available to confirm recent infection control training undertaken by all but the senior GP partner."

Positive

"These records provided the background to the significant event a description of the issues raised and the action taken We reviewed safety records incident reports and minutes of meetings where these were discussed."

Positive

"However there was no documentary evidence that all apart from two staff had undertaken update training since fire safety training during their induction including long standing members of staff."

Positive

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

Neutral

"We looked at the provider’s policies and records including staff recruitment and training files health and safety building and equipment maintenance infection control complaints significant events and clinical audits."

Neutral

"The practice also had a variety of other risk assessments in place to monitor safety of the premises Are services safe?"

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 information governance including confidentiality."

Positive

"• Ensure gaps in staff training in infection control and fire safety are addressed and evidence of all training completed is documented in staff records; and arrange for outstanding annual appraisals to be conducted for staff due one."

Positive

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

Positive

"For example there was no documentary evidence that all apart from two staff had undertaken update training since fire safety training during their induction and no details were available to confirm recent infection control training undertaken by all but the senior GP partner."

Neutral

"We looked at the provider’s policies and records including staff recruitment and training files health and safety building and equipment maintenance infection control complaints significant events and clinical audits."

Neutral

"There was an infection control policy in place."

Neutral

"All staff received induction training about infection control specific to their role."

Neutral

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

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

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

Positive

"• Survey information we reviewed was lower than average when patients were asked about being treated with compassion dignity and respect and their involvement in decisions about their care and treatment."

Positive

"They were mostly satisfied with the care provided by the practice and said their dignity and privacy was respected."

Positive

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

Positive

"We also issued requirement notices to the provider in respect of Fit and proper persons employed."

Positive

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

Neutral

"However some deficiencies remained in respect of the arrangements for prescription security and staff update training."

Positive

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

Positive

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

Positive

"They also 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."

Positive

"There were additional policies to guide staff in the handling of complaints and concerns covering being open a blame free culture whistleblowing dignity and respect and equal opportunities of service provision."

Positive

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

Positive

"Improvements were made to the quality of care as a result of complaints and concerns."

Positive

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

Positive

"They were mostly 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

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

Positive

"• Staff interviewed knew how to recognise signs of abuse in children young people and adults whose circumstances may make them vulnerable."

Neutral

"However there were examples of good practice: • Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns."

Positive

"There were procedures in place to safeguard children and young people from abuse and the senior GP partner was the named safeguarding lead for the practice."

Positive

"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 and those in at risk groups including vulnerable children and adults patients with learning disabilities and mental health problems."

Positive

"These included 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 and those in at risk groups including vulnerable children and adults patients with learning disabilities and mental health problems."

Neutral

"Health promotion advice was provided on diet smoking and alcohol cessation."

Positive

"A sign on the waiting room notice board encouraged carers to identify themselves to the practice team."

Neutral

"The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health and sign posted patients to the appropriate services."

Positive

"For example following a complaint about information conveyed by reception about the outcome of a blood test the practice advised the reception team about what information should be given to avoid patient confusion and anxiety."

Positive

"There was also advice about making a complaint in the practice leaflet made available to all patients and on the practice’s website."

Positive

"We saw meeting minutes where complaints were discussed for example a complaint about child immunisations where the process for recording immunisations was reviewed."

Positive

"There was also advice about making a complaint in the practice leaflet made available to all patients and on the practice’s website."

Positive

"Patients we spoke with were aware of the process to follow if they wished to make a complaint and one told us that they had complained and the matter had been resolved satisfactorily."

Positive

"• An overarching governance framework supported the delivery of the strategy and good quality care."

Positive

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

Positive

"• Strengthen governance arrangements regarding performance monitoring to ensure ongoing shortcomings in providing safe services and access to appointments are addressed."

Neutral

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

Positive

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

Positive

"It also contained the practice’s vision to work in partnership with its patients and staff to provide the best primary care services possible working within local and national governance guidance and regulations."

Positive

"There were governance arrangements in place through which risk and performance monitoring took place and service improvements were identified."

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 information governance including confidentiality."

Neutral

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

Positive

"There was evidence of quality improvement including clinical audit: • There had been five clinical audits commenced in the last two years and one of these was a complete audit where the improvements made were implemented and monitored."

Positive

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

Positive

"Clinical audits were carried out to demonstrate quality improvement in care and treatment and people’s outcomes."

Positive

"We were shown the staff handbook that was available to all staff which included sections on work standards sickness on equality harassment and health and safety at work."