Wonersh 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

At our inspection in April 2024, we reviewed 2 quality statement in the Safe key question – Learning Culture and Medicines optimisation and found good practice. There was a culture of safety and learning. Staff 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, safety alerts and complaints. Risks were actively managed and viewed as 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. 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 peoples’ care in line with current national guidance. Expiry dates of medicines were monitored, recorded and all in date. Fridge temperatures were in range and recorded daily. Medicines were stored correctly. However, we found prescription stationary was not always tracked within the practice and Patient Specific Directions (PSD) were not being adequately managed. At this assessment we found the provider had made the required changes to ensure that systems and processes were working as intended and was now compliant.

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

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.

The provider now ensured that the tracking of prescription stationary was robust, and staff had confirmed they were aware and understood the new system. We noted the provider had added a sequence of consecutive numbers to each prescription to ensure ease of tracking prescription stationary. Prescription details were recorded and signed out on a log sheet and when used patient information was also recorded. Any prescriptions not used were returned and the relevant prescriptions signed back on to the log sheet. Clinical rooms were checked each night by reception staff to ensure no blank prescriptions remained in the room. The provider sent us evidence of weekly audits and in the first month it was noted that the system was working well, and staff understood the process required. The provider told us they would move to monthly audits and then annually if there continued to be no concerns with the new way of working.

The provider had reviewed how PSDs were handled within the practice. PSDs were previously used by prescribing clinical staff, to delegate the task of administering flu vaccinations to Healthcare Assistants (HCA), who were trained to administer injections. A decision had been made to no longer use PSDs and instead only nurses or GPs would administer these vaccines through a patient group direction (PGD). PGDs allow specified health professionals to supply and/or administer medicine without a prescription or an instruction from a prescriber. For example, PGDs authorised by the NHS England regional team to support the national immunisation programme. We noted that the Prescribing and medication policy had been updated to reflect this change and all staff had confirmed they were aware of the new way of working.