Parks Surgery Limited Also known as Pennington Park Surgery

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 all the quality statements for this key question. Our rating for this key question is good. We found safety was high priority and we found that staff and leaders took all concerns seriously. We found that managers encouraged staff to report any incidents, and these were then investigated and analysed to reduce the likelihood of them being repeated. We saw a proactive and positive culture based on openness and honesty. We saw that lessons from incidents had been learned and were embedded into everyday practice. The numbers of staff employed at this service were adequate and there was a good mix of skills. We saw that the practice was clean and met the correct infection, prevention and control guidelines. Medicines were being stored correctly on the premises with correct policies and procedures in place.

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.

Members of the patient participation group told us that they found the practice manager and lead GP encouraged learning. Significant events were discussed at practice meetings which allowed for an open culture and for learning to be had by all staff. Members of the patient participation group felt that staff were well trained and knowledgeable.

We sent out questionnaires to staff and asked for feedback on how they found the learning culture at the practice. They told us that learning was encouraged and that at the monthly meetings any concerns that had been raised through the month were discussed. If needed the minutes of the meeting were shared with the staff team. Protected learning time was encouraged allowing staff to complete mandatory training. There was evidence of a good induction and mentoring period for new staff.

When we completed the onsite assessment, we found that were good processes in place for new starters, regular 1-2-1 meetings and appraisals for staff to allow them to indicate any learning needs. 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. Any significant events were discussed at the monthly staff meetings and there was a good process in place to highlight these at the earliest opportunity with the correct leader in place taking ownership of these.

The overall feedback from patients that we received was good. Patients felt that the correct systems and pathways were in place. We were told by patients that if they had a need to be seen outside of the practice by either an out of hours provider or hospital the records were updated correctly and in a timely manner.

Referrals to specialist services were appropriate and monitored and there was a documented approach to the management of test results. Staff had knowledge and understanding of local referral processes and arrangements. Staff had been trained to direct people to the most appropriate service. Although we did not identify areas of clinical risk in any of the clinical records reviewed the clinical searches did identify records where improvements could be made. Patients on high-risk medications did not have correct follow up timescales in place and there was a lack of literature sent out to these patients. The practice was responsive to feedback given as a direct result from our reviews and an action plan was implemented.

Feedback from partners about the practice was good. There were no concerns or issues raised at the time of the assessment. The practice had a good working relationship with the primary care network. The practice was working hard to engage with all partners.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. We saw several policies and processes about safe working practices for referrals, the management of tasks, the management of patient discharges from secondary care, medicines prescribing and partnership working. Staff were aware of protocols and aligned their working practice accordingly. There was a documented approach to the management of test results, and this was managed in a timely manner. Our searches showed no concerns for the management of test results.

We did not speak to people directly about safeguarding and there was no negative feedback received from patients prior to the inspection.

We saw that the practice worked with people to achieve the best outcomes regarding safeguarding. We saw an open culture where staff understood how to report and act on any safeguarding concerns. There were safeguarding registers which were updated and regular safeguarding meetings where vulnerable patients were monitored and discussed to ensure they were receiving the required care and treatment. Safeguarding policies and procedures were in place, we saw that staff were able to access them easily.

Feedback from partners was positive. We were told that the practice integrated well with other organisations such as the primary care network and attended multidisciplinary meetings where people on safeguarding registers were discussed and their care was monitored. There was a shared care approach. We saw that there was duty of candour in place and that people’s human rights were protected.

Safeguarding registers and regular staff meetings kept the practice up to date with any patients who could be at risk. This increase in monitoring helped to keep patients safe from harm. Staff had been trained to appropriate levels and training was monitored to keep it up to date. All staff were aware of who the safeguarding lead was at the time of assessment and the designated contact information of the safeguarding lead was available at all times.

During discussions with members of the patient participation group people told us they knew what to do and who to contact when they realised that things might be at risk of going wrong or their health condition may be worsening.

Staff told us that patients were able to request home visits to meet their care needs. Staff had sufficient training to support them in helping patients with differing needs and medical conditions.

We saw evidence of staff training and evidence of staff using new ways to navigate patients to the right person, right place, right time. There was a process to manage urgent referrals which involved raising tasks on the system.

Leaders and staff considered how environments could keep people safe from psychological harm as well as physical harm. Quiet private spaces near to the main waiting areas were offered if patients asked to speak privately with staff.

The waiting room was clean, the chairs were all in good repair and could be wiped down and disinfected as required. The facilities, equipment and technology were well-maintained and consistently supported staff to deliver safe and effective care. Equipment used to deliver care and treatment was suitable for the intended purpose, stored securely and used properly. There was adequate personal protective equipment in all clinical rooms, the curtains and sharps bins were all in date. There were correct arrangements in place for managing clinical and non-clinical waste with the appropriate procedures in place to support these arrangements.

Policies and procedures in place were appropriate and had all been reviewed and updated. The provider had appropriate infection control, health and safety, fire and premises risk assessments and action plans in place to keep the environment safe for people.

When we spoke to members of the patient participation group as part of the assessment, they told us that they found that there were enough staff employed at the practice to meet the needs of those registered with the practice. Members also explained that there was a wide range of staff with different specialities available to them. We were also told that there were enough staff able to help with queries at the first point of contact.

We saw that there was enough staff in place that followed a 2-week rota pattern and any shortfalls due to sickness or leave were picked up by staff offering to work overtime to meet the needs of the service. Training and mentoring and induction periods were role specific and adequate for the roles being undertaken. Staff were able to demonstrate safe systems and pathways. Referrals to specialist services were appropriate and monitored and there was a documented approach to the management of test results.

Staff received training appropriate and relevant to their role. Recruitment checks were carried out in accordance with regulations. When we spoke to staff, they told us that they had good clinical supervision. Staff told us that the supervision that they had was supportive and helped them to develop as individuals. Supervision was in place for all clinical and non-clinical staff and took place on a regular basis.

There was no specific feedback from people about infection prevention and control.

Staff knew who the infection prevention and control lead for the practice was. They felt supported in understanding infection prevention and told us they received appropriate training, such as hand washing. Staff who handled clinical specimens knew how to do so safely.

The premises were clean, and equipment used was well maintained which helped to protect patients and visitors from the spread of infection. The chairs in the waiting room were wipeable, sufficient personal protective equipment and hand washing facilities were available in clinical areas. Clinical staff were observed as bare below the elbow as per guidelines.

There were clear roles and responsibilities around infection prevention and control. There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. The provider completed regular hand washing and infection control audits, the results of these had been actioned to improve compliance.

We did not speak to people directly about medicines optimisation and there was no negative feedback received from patients prior to inspection.

Staff and leaders were all aware of their roles and responsibilities surrounding medicines management. Clinical meetings were attended by clinical staff to discuss the safe prescribing of medicines, medical safety alerts and patient concerns. Staff received regular training on medicines management, and felt confident managing the storage, administration and recording of medicines.

Staff managed medicines safely. At the time of assessment, the practice was gearing up for a mass flu campaign to be run at the weekend and they had a lot of vaccines stored within the fridges. This was discussed as there was poor airflow around the vaccines due to the number being stored and evidence was provided showing that the vaccines had only been on site for a few days and would soon be used. Medical gases were appropriately stored with correct signage in place. Not all the emergency medicines were in place on the day of our assessment. The provider has since taken action to rectify this and provided evidence to show these are now available. The provider checked the emergency medicines and equipment monthly.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff managed medicines-related stationery appropriately and securely. Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. Medicine reviews were well documented.

There were meetings between nurses and pharmacists where audits and medical alerts were discussed, and appropriate actions were taken. Staff took steps to ensure they prescribed medicines appropriately to optimise treatment outcomes, including for the prescribing of antibiotics.