What is the Quality of Safety at Tunstall Primary Care

Neutral

"This provided patients with guidance on lifestyle diet and medication."

Positive

"The registered person had systems or processes in place that operating ineffectively in that they failed to enable the registered person to ensure that accurate complete and contemporaneous records were being maintained securely in respect of each service user."

Neutral

"The registered person had systems or processes in place that operating ineffectively in that they failed to enable the registered person to evaluate and improve their practice in respect of the processing of the information obtained throughout the governance process."

Positive

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

Positive

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

Positive

"• Data from the national GP patient survey showed that patient satisfaction was in line with other practices in the clinical commissioning group CCG and national averages for questions related to kindness respect and compassion."

Positive

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

Positive

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

Positive

"• Staff took steps including working with other agencies to protect patients from the risk of abuse neglect harassment discrimination and breaches of their dignity and respect."

Positive

"• Staff recognised the importance of maintaining patients’ 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

"• Evidence we reviewed demonstrated that patients were satisfied with how they were treated and that this was with compassion dignity and respect."

Positive

"The evidence from both these sources showed patients were satisfied with how they were treated and that this was with compassion dignity and respect."

Positive

"Patientcarer support to cope emotionally with care and treatment The GP patient survey information we reviewed showed patients were positive about the emotional support provided by the practice."

Positive

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

Positive

"They told us they had confidence in the staff and they were always treated with dignity and respect."

Positive

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

Positive

"They said staff treated them with dignity and respect."

Positive

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

Positive

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

Positive

"In particular: • Their internal governance arrangements continue to be responsive and reliant on external oversight."

Neutral

"The registered person had systems or processes in place that operating ineffectively in that they failed to enable the registered person to evaluate and improve their practice in respect of the processing of the information obtained throughout the governance process."

Positive

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

Positive

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

Positive

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

Positive

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

Neutral

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

Positive

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

Positive

"We based our judgement of the quality of care at this service on a combination of: • what we found when we inspected • information from our ongoing monitoring of data about services and • information from the provider patients the public and other organisations."

Positive

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

Positive

"We based our judgement of the quality of care at this service on a combination of: • what we found when we inspected • information from our ongoing monitoring of data about services and • information from the provider patients the public and other organisations."

Positive

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

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

"• Up to date fire drill logs and health and safety checks were available at the main practice."

Positive

"• Up to date fire drill logs and health and safety checks were not readily available at the main practice."

Positive

"• Liaise with the landlord of the main practice premises to provide reassurance that fire drills are logged and health and safety checks are carried out and documented."

Positive

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

Positive

"However risk assessments were not always completed to mitigate safety risks to patients."

Positive

"• Comprehensive risk assessments in relation to safety issues were not always in place or lacked effective detail."

Positive

"However: • Comprehensive risk assessments in relation to safety issues were not always in place or lacked effective detail."

Positive

"Track record on safety The practice did not have a full track record on safety."

Positive

"• The practice acted on and 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 however some of these polices needed updating to reflect current guidance."

Positive

"Practice leaders had oversight of national and local safety alerts incidents and complaints."

Positive

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

Positive

"However risk assessments in relation to patient safety had not always been completed."

Positive

"Assessments of some of the risks to the health and safety of service users of receiving care or treatment were not being carried out."

Positive

"The registered persons had not done all that was reasonably practicable to mitigate risks to the health and safety of service users receiving care and treatment."

Positive

"The building administrator showed us their risk assessments for potential issues such as Control of Substances Hazardous to Health COSHH fire safety buildings and prevention of the legionella virus."

Positive

"Information about safety was recorded monitored appropriately reviewed and addressed."

Positive

"Monitoring safety and responding to risk The practice had systems processes and policies in place to manage and monitor risks to patients staff and visitors to the practice."

Positive

"Learning and improvement from safety incidents The practice had a system in place for reporting recording and monitoring significant events incidents and accidents."

Positive

"The practice was able to evidence through discussion with the GPs and practice manager and via documentation that there was a clear understanding among staff of safety and of learning from incidents."

Positive

"For example reported incidents and national patient safety alerts as well as comments and complaints received from patients."

Positive

"National patient safety alerts were disseminated by the practice manager to practice staff."

Positive

"Reliable safety systems and processes including safeguarding The practice had systems to manage and review the risks to vulnerable children young people and adults."

Positive

"The practice also had a health and safety policy."

Neutral

"Our key findings were as follows: • Patients were kept safe because there were arrangements in place for staff to report and learn from key safety risks."

Neutral

"We found clear procedures were in place for reporting safety incidents complaints or safeguarding concerns."

Positive

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

Positive

"All 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 and treatment rooms so that patients’ privacy and dignity was maintained during examinations investigations and treatments."

Neutral

"Staff and patients told us that all consultations and treatments were carried out in the privacy of a consulting room."

Neutral

"A notice about confidentiality was on display on the reception desk and a privacy booth was available for patient use."

Positive

"• Staff took steps including working with other agencies to protect patients from the risk of abuse neglect harassment discrimination and breaches of their dignity and respect."

Positive

"Safety systems and processes The practice had systems to keep people safe and safeguarded from the risk of abuse however they were not always followed."

Positive

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

Positive

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

Positive

"The practice worked with other services to prevent abuse and to implement plans of care."

Positive

"• Information about how to make a complaint or raise concerns was not readily available for patients to access within the practice."

Positive

"None of the patients we spoke with had ever needed to make a complaint about the practice."

Positive

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

Positive

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

Positive

"Cleanliness and infection control All of the patients we spoke with during the inspection told us that the practice was always clean and tidy."

Positive

"For example: infection control chronic kidney disease and chronic obstructive pulmonary disease."

Positive

"An infection control policy and supporting procedures were available for staff to refer to which enabled them to plan and implement infection control measures."

Neutral

"All staff had undertaken infection control training and the practice nurse was the infection control lead."

Neutral

"The practice nurse told us they needed to start recording when infection control issues were discussed at practice meetings."

Neutral

"For example the practice nurse was the lead nurse for infection control and one of the GP partners was the lead for safeguarding."

Positive

"Staff told us they had a very good working relationship with the health visitor attached to the practice."

Positive

"Systems were in place identifying children who were at risk and there was a good working relationship with the health visitor attached to the practice."

Positive

"Tackling inequity and promoting equality The practice proactively removed any barriers that some people faced in accessing or using the service."

Neutral

"The practice provided equality and diversity training through elearning."

Positive

"Staff told us that these patients were supported to register as either permanent or temporary patients as the practice had a policy to accept any patient who lived within their practice boundary irrespective of ethnicity culture religion or sexual preference."

Positive

"They told us all patients received the same quality of service from all staff to ensure their needs were met."