The Hollies Surgery Also known as Vida Healthcare

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

The practice provided care in a way that kept patients safe and protected them from avoidable harm.

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.

The practice learned and made improvements when things went wrong. Staff knew how to identify and report concerns, safety incidents and near misses. There was evidence of learning and dissemination of learning. Staff could attend regular meetings held face to face and via a video link. Minutes were available for those unable to attend. Feedback we received from staff was positive about the learning culture within the practice.

The practice had systems and processes in place to manage any safety events. They demonstrated how they investigated, identified learning and any improvements that were required. We saw the practice recorded events to ensure they were managed in a timely way. We reviewed some ways the practice shared learning with staff such as team meetings, where minutes of meetings were taken which demonstrated a formal approach to managing learning. Staff confirmed they had attended meetings and had access to the minutes.

Patients we spoke with told us that when they have complained or given feedback about their concerns the practice told them they had investigated the issue and where possible had made changes.

Staff had the information they needed to deliver safe care and treatment. Individual care records, including clinical data, were written and managed securely and in line with current guidance and relevant legislation. There were systems for sharing information with staff and other agencies to enable them to deliver safe care and treatment. Referrals to specialist services were documented, contained the required information and there was a system to monitor delays in referrals. There was a documented approach to the management of test results and this was handled in a timely manner.

The practice had clear systems, practices and processes in place to keep people safe and safeguarded from abuse. Staff were trained and knowledgeable about the systems and were confident to raise any concerns they had. There was active and appropriate engagement in local safeguarding processes. There were regular discussions between the practice and other health and social care professionals such as health visitors, school nurses, community midwives and social workers to support and protect adults and children at risk of significant harm.

We spoke with a member of the patient participation group who told us the practice were open to discussing any concerns raised in respect of safety. The member told us the practice were challenged with space at the practice and managed risk associated with this well. They told us they had no concerns about the environment or staffing levels, although acknowledged additional staff would be a benefit.

Staff told us there were adequate systems to assess, monitor and manage risks to patient safety. There were enough staff to provide appointments and prevent staff from working excessive hours. There was an effective approach to managing staff absences and busy periods. Staff told us this was achieved by cohesive team working and staff who were able to worked additional hours as necessary. There was an effective induction system for new staff tailored to their specific roles. Staff gave example of how they had been part of inducting new staff and how they had been supported when undertaking new roles with the practice. There were ongoing plans to further recruit more GPs and non-clinical staff to meet the demands of the growing practice population list.

The practice demonstrated a proactive approach to using risk assessments to identify and mitigate risks. For example, we reviewed a sample of risk assessments such as health and safety, fire risk, and legionella disease. Risks had been identified and actions taken to mitigate the risk. Where necessary, the practice liaised with the owner of the premises.

The practice leaders and staff told us they were challenged with lack of space from which to provide services to patients. The practice told us they were having discussions with the landlord regarding additional space which would enable them to increase services that could be offered to patients.

During our on-site visit we observed the practice to be clean and uncluttered. Fire accesses were clear and fire safety equipment easily available.

The practice demonstrated that recruitment checks were carried out in accordance with regulations including for locum staff. The practice had a process of ensuring they had recorded the vaccination status of staff in line with current UK Health and Security Agency (UKHSA) guidance if relevant to their role. Staff who were responsible for reviews of patients with long-term conditions had received specific training.

Feedback we received from patients was generally positive about staffing. Comments we received directly from patients and care home representatives, through Healthwatch and the NHS reviews website were positive in respect of staffing. Some comments indicated a delay in answering the telephones, the practice recognised that additional staff needed to be deployed into that role at peak times.

During our on-site visit we observed the practice to be clean and tidy. We found systems in place for cleaning of equipment within the clinical rooms. We did not identify any concerns relating to IPC.

Feedback we received from patients was positive in respect of the cleanliness of the environment. We noted that some patients reported that this had improved over the past months.

Appropriate standards of cleanliness and hygiene were met. Staff had received training and had carried out a detailed infection, prevention, and control (IPC) audit. They had systems to monitor that actions had been completed. For example, improving the documentation to record that equipment had been cleaned after consultations.

We received feedback from staff, either those we spoke with or via the staff questionnaire we sent. The staff told us they were aware of who the leads were and had no concerns about the IPC processes. Staff told us there were systems in place for dealing with specimens and bodily fluid spills. A full IPC audit was undertaken by practice staff and the Integrated Care Board IPC team. Where improvements were required, these had been actioned, or there was a plan in place. Discussion of IPC had been held in various meetings such as the regular nurse meeting.

As part of the assessment, we conducted searches on the practice clinical system and reviewed a selection of patients records. There was a process for monitoring patients’ health in relation to the use of medicines including medicines that require monitoring for example, warfarin, methotrexate and lithium. We reviewed some patient records and found there was appropriate monitoring and clinical review prior to prescribing the medicines for all patients taking these medicines. The practice had taken steps to ensure appropriate antimicrobial use to optimise patient outcomes and reduce the risk of adverse events and antimicrobial resistance. Regular reviews and feedback to staff was given to ensure medicines such as antibiotics were prescribed in line with current guidance. An area the practice had identified, and our searches confirmed needed further monitoring was to ensure patients who had been prescribed 2 or more doses of steroids within 12 months were followed up within an appropriate time frame. The practice told us and showed evidence that their policy and learning to staff had been updated. A regular monitoring search had been implemented to ensure the improvement was sustained. The practice held appropriate emergency medicines, risk assessments were in place to determine the range of medicines held, and a system was in place to monitor stock levels and expiry dates. Vaccines were appropriately stored and monitored in line with UKHSA guidance to ensure they remained safe and effective. There was a system for recording and acting on safety alerts. Minutes of meetings demonstrated that all clinical staff were kept up to date with any changes to guidelines and best practice. Staff had the appropriate authorisations to administer medicines including Patient Group Directions or Patient Specific Directions.

There was a process for the safe handling of requests for repeat medicines and evidence of effective reviews for patients. The practice had a process and clear audit trail for the management of information about changes to a patient’s medicines including changes made by other services. Medicines prescribed in hospital were added to the clinical records. GPs approved all medicines added to the prescribing page before any were issued.

The practice told us and staff confirmed that new procedures had been implemented over the past months to ensure medicines were managed safely. Additional staff had been employed and trained; staff had been engaged in improving the recall system for patients requiring monitoring. The teams worked cohesively to ensure every contact counted and to reduce the number of appointments that patients needed to attend. Regular searches and audits were in place to ensure the practice delivered timely reviews. Clinical staff had received additional training and advice on completing templates and reviews documentation to evidence that all medicines had been reviewed.

Feedback we received from care home representatives were positive about their experience on behalf of their residents in respect of managing medicines. They told us the practice was proactive in regular reviews of patient medicines. When acute medicines such as antibiotics were required the practice organised these in a timely way.