Novum Health Partnership

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 8 quality statements from this key question. The rating for safe at our last inspection was inadequate. Following this assessment, this key question is now rated as good. We found there were clear, effective care pathways. Risks were recognised and managed appropriately. Processes were in place to enable response to medical emergencies. Some patients had not received all appropriate monitoring and follow up tests, however the provider was aware of this and had taken action to improve monitoring. Staff and patients told us they felt there was insufficient administrative staff. Not all non-clinical staff had completed safeguarding training at a level appropriate to their role. This was in breach of Regulation 18 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were able to raise concerns and told us they felt listened to by leaders at the practice. Patients told us it was easy to contact the practice should they wish to make a complaint.

All of the staff we spoke to were aware of how to raise incidents. Staff we spoke to detailed how learning was shared with them on both an individual basis, and organisation wide. Leaders detailed how they supported the process, and staff as required.

There was a system for recording and acting on significant events and incidents. There were adequate systems for reviewing and investigating when things went wrong. The service learned and shared lessons, identified themes and took action to improve safety. The service learned from external safety events and patient safety alerts and had an effective mechanism in place to review alerts and disseminate them to members of the team as required.

Patients reported effective systems for contacting the practice for appointments, test results and referrals.

The staff we spoke to were all aware of care pathways, including referrals and taking on care of those patients who had been discharged from other services. Staff told us that there had been a delay in managing incoming correspondence, including test results, but that recent recruitment to a new role had resolved this. Leaders at the service shared relevant information with staff in team meetings.

The provider worked with partners to ensure patients had access to appropriate support, for example those patients receiving palliative care.

The service had processes in place to ensure that referrals and discharges were managed quickly. There were also systems in place to ensure that where care was shared, information was shared between organisations, for example where blood tests and monitoring were undertaken by another provider.

We found no concerns regarding people’s experiences of safeguarding.

Staff were aware of how to access practice safeguarding policies and knew who the practice safeguarding leads were. Staff were able to explain how they would raise safeguarding concerns.

The provider worked with partner organisations to share information about patients on the practice’s safeguarding register. There were regular meetings with multidisciplinary teams to discuss patients on the safeguarding register.

There were clear safeguarding policies and pathways and we found evidence staff were following these policies. We reviewed the provider’s training records and found clinical staff had completed training in safeguarding adults and children at a level appropriate to their role. However, the provider had not identified that the safeguarding training completed by non-clinical staff did not meet the minimum suggested training requirements.

Patients told us they felt involved in their care and treatment. Treatment was explained to patients in ways they could understand and people were given options for their treatment.

Leaders told us that staff were informed in managing risk, and that standing items such as safeguarding and incidents were discussed at meetings. Staff reported that they were included in risk management, and that they were happy to report when things went wrong. However, clinical staff told us that they generally only attended clinical meetings if they had a case to present.

There were processes in place for risks to be discussed with all staff. We observed the service was equipped to respond to medical emergencies, including suspected sepsis, and all equipment was regularly checked. The practice had protocols in place to manage the prioritisation of patients. Staff had completed basic life support, anaphylaxis, and sepsis training.

Staff at the service were aware of where all emergency equipment was stored. Leaders at the service were able to detail the policies and procedures that were in place to ensure that the environment was safe.

We observed that the building in which the service was in place was fit for use. All equipment had been checked and calibrated as required. The service had a full range of emergency medicines and equipment (such as a defibrillator and oxygen) in place to ensure that emergencies could be safely managed.

The provider held medicines and equipment to enable response to medical emergencies. There were processes to ensure emergency medicines and equipment were checked regularly. The provider had risk assessed the environment and, where appropriate, taken action to ensure identified risks were removed or reduced.

Patients told us they felt there were sufficient clinical staff to meet patient need. Patients also told us they felt there were not enough administrative staff. The National GP Patient Survey conducted in 2024 showed lower than average patient satisfaction with the overall experience of contacting the practice, and with how easy it was to contact the practice by telephone.

Staff reported that in some areas there were sufficient staffing at the service. However, they reported that the level of administrative staffing even when it was at complement, was insufficient. Leaders told us that they had worked hard to recruit to posts, and that they had reviewed the role and salary structure in order to elicit more applications. They told us they would continue to recruit until such time that staffing was at complement.

The provider was aware of the issues relating to insufficient number of administrative and reception staff and were in the process of recruiting to these roles. There were processes in place to ensure pre-employment checks took place before staff commenced work in the practice. There was an induction process for new starters and staff received regular appraisals. The provider had a protocol to assign training to staff at the beginning of the year to complete all mandatory training. We saw an example where a member of staff was overdue training in infection prevention and control, safeguarding adults, and safeguarding children training. However this had not been identified by the practice as the protocol suggested training did not need to be completed until the end of the year. Following our site visit the provider told us they would amend the process for assigning mandatory training for staff. We were also provided with evidence the member of staff identified had completed the necessary training.

Patients told us they found the premises to be clean and tidy. Patients said they observed staff washing their hands before and after examinations and wearing gloves.

Leaders told us that they had implemented cleaning schedules at the service, and regular monitoring of cleanliness was in place.

The service was clean, and all of the clinical areas at the practice were fit for use. Curtains were changed regularly, and sharps and other clinical waste management was managed appropriately.

At our previous inspection in October 2023, the provider could not demonstrate staff had received immunisations appropriate to their roles, and there was not an effective system for recording which staff were up to date with routine immunisations. At this assessment in September 2024, we found that details of immunisation status of staff were kept and requested as part of the recruitment process. There were processes in place to record the immunisation status of staff in line with best practice guidance.

We carried out searches on the practice’s clinical records system. We found some patients did not always receive the appropriate monitoring and follow up tests. For example, some patients prescribed a medicine to treat high blood pressure, and some patients with asthma who were prescribed a rescue steroid.

As part of our clinical searches we looked at patients prescribed a medicine to treat high blood pressure. We identified 67 patients who had not had the required monitoring tests. We reviewed 5 of these patients in detail and found 4 patients were overdue monitoring tests. We shared our findings with the provider. The provider demonstrated examples where action had previously been taken to encourage patients to attend for monitoring tests, for example by using different methods to contact the patient and reducing the amount of medicine prescribed at one time. The provider also had an action plan detailing how they planned to encourage patients to attend for required tests in the future.

As part of our inspection a number of set clinical record searches were undertaken by a CQC GP specialist advisor. These searches were visible to the practice. We found that monitoring was appropriate in most cases. However, in some cases this was not the case. For example, we found that there were 33 occasions in the past 12 months where single patients on the asthma register had been prescribed rescue steroids twice. We reviewed 5 of these records, and found that in two cases the patient should have been followed up following the prescription of steroids, but were not. However, in the majority of cases where follow ups were required, the service was regularly contacting patients as required.

At our previous inspection in October 2023, we found the provider had written protocols for repeat prescribing, however these protocols had not been implemented effectively. At this assessment in September 2024 we saw evidence written procedures were being implemented effectively. Whilst we found some patients hadn’t received all necessary monitoring tests, the provider had documented the actions taken in attempts to engage with patients.

Staff took steps to ensure they prescribed medicines appropriately. Prescribing data reviewed as part of our assessment confirmed this. For example, prescribing of antibiotics was lower than national averages.