Green Porch Medical Centre

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed a total of 3 quality statements from this key question. We have combined the scores for these areas with scores based on the rating from the last inspection, which was Good. Our rating for this key question remains Good. We found safety was a top priority, and staff took all concerns seriously. When things went wrong, staff acted to ensure people remained safe. Managers investigated all reported incidents to reduce the likelihood of them happening again. Staff provided people with support and information on their care and treatment. The practice’s systems for the appropriate and safe use of medicines, including medicines optimisation were effective. The practice had effective systems for ensuring people were routinely contacted regarding medicine reviews and tests required to support these. People's medicines were routinely assessed, and care and treatment was delivered in line with current legislation, standards and evidence-based guidance.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Data from the National GP survey, NHS website, the practices own survey and feedback provided to CQC via our website, identified some areas of concern. We reviewed these during our site visit and found the provider had contacted the people involved and had conducted further consultations to ensure their care and treatment met their needs. Feedback from people after further consultation was positive; with people feeling supported to raise concerns and feeling staff treated them with compassion and understanding.

The practice management team encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from both clinical and non-clinical issues. Staff felt there was an open culture, and that safety was a priority.

The provider had processes for staff to report incidents, near misses and safety events. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that improved care for others.

Feedback provided to CQC via our website, identified some areas of concern relating to continuity of care between services. We reviewed these during our site visit and found the provider had contacted the people involved and taken appropriate action to ensure their social, care and treatment needs were met. Feedback from people after further actions were taken was positive; with people feeling listened to and that staff supported them.

Evidence reviewed showed that care and support was planned and organised with people, together with partners and communities in ways that ensured continuity and that the views of people who used the service, partners and staff were listened to and taken into account.

Partners provided CQC with feedback about the positive actions taken by the provider, to ensure a person who had been changed between secondary services remained with the one of their choice and not the one determined by local policy.

Policies and processes about safety were aligned with other key partners who were involved in people’s care journey; to enable shared learning and drive improvement.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Feedback provided to CQC from people via our website stated that medicine reviews were not occurring. We reviewed these people's records during our site visit and found people were involved with assessments and reviews, which included the level of support they needed to manage their medicines safely. People also provided us with feedback to show if their medication had to change, they knew why and were involved in the decision.

Staff received regular training on medicines management, and felt confident managing the storage, administration and recording of medicines. Staff managed medicines-related stationery appropriately and securely. Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring.

Staff managed medicines safely and regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. We completed a series of searches on the practice’s clinical records system. These searches were completed with the consent of the provider, and to review if the practice was assessing and delivering care and treatment in line with current legislation, standards and evidence-based guidance. Our clinical record searches found improvements had been sustained in relation to the safe management and monitoring of high-risk medicines and people with long-term conditions.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antibiotics issued by the provider was lower than local and national averages. There was a programme of regular clinical auditing of prescribing that focused on improving care and treatment.