Austen Road 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 reviewed 2 quality statement in the Safe key question – Learning Culture and Medicines optimisation. The scores for the other quality statements are based on the previous rating for this key question. There was a culture of safety and learning. Staff we spoke with told us they were encouraged to raise concerns and felt supported in doing so. Incidents and complaints were appropriately investigated and reported. There was an effective system for reporting, recording, and learning from significant events and complaints. Risks were actively managed and viewed as an opportunity to learn and improve. Our review of the remote searches of patient records showed that patients were being effectively and safely managed. There was a process for the management of medicines, including high risk medicines, with appropriate monitoring and clinical review prior to prescribing. Patients were involved in regular reviews of their medicines. Medicine management was effective. Expiry dates of medicines were monitored, recorded and all in date. Fridge temperatures were recorded daily and no temperatures had gone out of range. Medicines were stored correctly either in locked cabinets or locked fridges.

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.

We spoke with 2 members of the Patient Participation Group. Both told us they had positive engagement with the practice and felt that the practice wanted to learn and was proactively asking for feedback. We noted that the practice had received 8 complaints in the last year. We saw evidence that all had been investigated and patients were kept up to date with outcomes. In the reception area we saw a notice board with information for patients on the complaint procedure as well as comment cards for patients to use.

Clinical staff we spoke with were able to describe how they kept up to date with evidence-based practice. Staff we spoke with and minutes to meetings we reviewed, evidenced that clinical issues were regularly discussed between members of the team at practice meetings. There was a system for recording and acting on significant events. Staff we spoke with told us there was a no blame culture and staff felt able and were encouraged to raise concerns.

There were systems for reviewing and investigating when things went wrong. The practice learned and shared lessons identified themes and took action to improve safety in the practice. When things went wrong, staff apologised and gave patients honest information and suitable support. We noted an open culture in which all complaints were highly valued as being integral to learning and improvement. The practice had a complaints policy in place which clearly outlined the complaints process. This was accessible to patients within waiting areas, upon request from reception and on the practice website. The practice kept a record of all complaints received and any action taken as a result of complaints. Staff we spoke with were aware of how to support patients to make a complaint. There had been 10 significant events in the last 12 months, and we saw incidents were investigated fully. There was evidence that changes had been made as a result of identified learning. Meetings were held regularly where significant events were discussed for a wider learning. The practice had a protocol in place for actioning safety alerts. Alerts were disseminated to the required members of the team and where action was required, searches were conducted of clinical records to identify patients who may be affected. Alerts and any action taken was stored centrally so that all staff could access. From a sample of patients’ records we reviewed, we found action had been taken on alerts received.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

During the onsite inspection we found that the fridges were being monitored and recorded daily. Staff we spoke with told us the actions they would take if the fridge temperature went out of range. Emergency medicines were securely stored, accessible and with use by dates monitored. Prescription stationary was removed from clinical rooms and stored in a locked cabinet. Their use was monitored and centrally recorded. However, we found that a box of prescription stationary was stored openly in a room that was accessed by various staff members, therefore not securely stored. We bought this to the attention of the practice manager who moved the box to a cabinet that could be locked. We reviewed 3 Patient Group Directions (PGDs). PGDs provide a legal framework that allows some registered health professionals to supply and/or administer specified medicines to a pre-defined group of patients, without them having to see a prescriber such as a doctor or nurse prescriber. The PGDs we reviewed were signed and dated by the nurses and then authorised by a GP. We noted that one PGD was signed correctly, however, there was a discrepancy in the other two. We discussed this with the practice manager and the registered manager, who took immediate action.The day after the onsite inspection we saw evidence that the signature sheets had been updated and correctly signed and dated.

The national patient survey does not have questions specific to this question. We received 24 CQC Give Feedback on Care forms from patients. These were all positive. We also received comments, including a patient telling us they had received a follow up call from the GP to check how they were, comments relating to quick referrals, tests and reviews being completed in a timely manner and discussing treatment options.

Our review of the remote searches of patient records showed that patients were being effectively and safely managed. This included medicines that required monitoring and the follow up of abnormal test results. Our review of searches indicated patients care and treatment was managed in line with current guidance and that information, including, examination, management plans, safety netting and follow ups were adequately documented. Patients who were prescribed medicines were being monitored and reviewed in the required timescales. This ensured all information required was available for safe prescribing.

There was a process for the safe handling of requests for repeat medicines and evidence of effective medicines reviews for patients on repeat medicines. Patients were appropriately involved in decisions about their medicines. 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. There was a process for monitoring patients’ health in relation to the use of medicines including high risk medicines with appropriate monitoring and clinical review prior to prescribing. The practice monitored the prescribing of controlled drugs. The approach to medicines reflected current and relevant best practice and professional guidance. Medicines were appropriately prescribed in line with the relevant legislation, current national guidance or best available evidence. Patient records were well written and held up-to-date information about people’s care in line with current national guidance.

Staff we spoke with were knowledgeable about systems and processes within the practice that enabled positive patient care. Staff told of the process to ensure appropriate clinical oversight of test results. Clinical staff were able to tell us about how they monitored patients’ health in relation to the use of medicines including high risk medicines.