The Lawson Practice

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 provider had a comprehensive safety system and a focus on openness, transparency, and learning when things went wrong. Staff met good practice standards described in relevant national guidance. Patients were involved in their care and treatment and, for the most part, were reviewed appropriately.

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.

Two out of three patients told us they did not know how to make a complaint at the surgery. Staff could not provide us with a complaint’s information leaflet, which they could give to patients to outline the complaint process upon request. However, the practice website's complaints section directed patients to a complaints form, which they could complete online and send directly to the practice. This method, along with other practices, such as texting patients for feedback following their appointments, significantly increased patient feedback between January 2023 and March 2024. Following the factual accuracy process (which allows providers to review the report and ensure the assessor has considered all relevant information that will form the basis of CQC's judgements), the provider told us that staff inform patients how to make a formal complaint when needed and have complaint forms to give to patients and will complete the form on behalf of a patient if they are unable to do so themselves; alternatively, patients can write directly to the practice manager. Patient feedback obtained from external sources such as the national GP patient survey and NHS Choices were predominately positive.

Staff and leaders understood their duty to raise concerns and report incidents and near misses. Staff and leaders were able to share examples of incidents and complaints which had been investigated and actions identified. Learning from incidents and complaints were shared with staff and agreed actions followed up. Feedback from staff and leaders demonstrated that the practice had a culture of identifying incidents and complaints, learning and improvement. Staff told us they felt they were able to raise concerns and report when things went wrong.

The practice had a significant events policy and a reporting form which was accessible to all staff members. The practice followed their significant events policy and discussed events and incidents during team meetings and learning was shared with staff. The practice had a duty of candour policy and involved people when managing significant events and errors. There was a clear system in place to record and investigate complaints. From the sample of complaint records we reviewed, we found the practice responded to people’s complaints in a timely manner. The practice offered apologies to people, and action was taken to improve the quality of care.

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.

The practice maintained a good standard of cleanliness and hygiene. There were reliable systems in place to prevent and protect people from a healthcare associated infection. Arrangements were in place to manage waste and clinical specimens. The practice was equipped to respond to medical emergencies and staff were suitably trained in emergency procedures.

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.

People told us that they were able to get an appointment when they needed and were appropriately involved in decisions about their medicine. Results from the practice's latest GP patient survey showed: The practice was inline with the local and national average for the percentage of people that felt they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment.

Staff and leaders told us they had systems and processes in place to support the safe prescribing of medicines. We saw evidence that staff and leaders met regularly to review their prescribing and management of patients receiving high-risk medicines and medicines which require monitoring.

During our checks we found all medicines were stored securely. Prescription paper was stored securely and the practice maintained a record of prescription paper serial numbers. Emergency equipment and medicines were checked on a regular basis. Vaccines were ordered and stored in accordance with national guidelines and the practice has systems in place to monitor the temperature of vaccine fridges.

The practice had documented protocols in place for the management of medicines including a protocol for handling high-risk medicines. During our clinical searches we found structured medicine reviews were carried out. The practice had systems to monitor the appropriateness of non-medical prescribers and clinical supervision was in place. There were good systems in place for the safe and effective management of clinical correspondence. Accurate and up-to-date information about people’s medicines was available. The practice had a system in place to receive, review and act on safety alerts. There were processes to monitor and manage patients receiving medicines which required monitoring. The practice held weekly meetings to review progress against their strategy and shared the meeting minutes with all practice members. A recall team was created to contact patients and follow up on missed appointments; they also had a specialist administrator who took the lead as a contact for patients in specific areas such as child immunisations and baby checks. Additionally, they had a medical assistant who opportunistically monitored and checked the health of patients who attended the practice. Following the factual accuracy process, the provider told us that they discussed cases and strategies during clinical meetings to ensure everyone is up to date about the ongoing plans. We saw evidence that the provider gave the reception staff a list of patients who would be discussed during the clinical meetings and encouraged them to add the names of any patients they thought should be addressed.

The practice completed annual health reviews for patients with long-term health conditions and those on registers such as people with a learning disability. These registers were reviewed regularly, and reports run to identify any on-going monitoring needs for patients. During the searches undertaken as part of the remote assessment we found effective structured medicine reviews were carried out. There were a small number of patients whose monitoring was overdue. Our GP specialist advisor found 33 patients with asthma who were prescribed two or more courses of rescue steroids. We looked at five patient records and identified that all five asthma patients had not had a follow-up to check their response to treatment within the required timeframe (one week), and one of the patients did not have an asthma review within the last 12 months. During the remote GP interview, the provider told us they had identified the issue and had a plan to rectify it. Following the factual accuracy process, the provider told us they had introduced additional appointments to review patients 48 hours after being prescribed two or more courses of rescue steroids. End of life care was delivered in a coordinated way which considered the needs of those whose circumstances may make them vulnerable. The practice's performance in prescribing was above the national and local average in two out of five indicators and was in line with the averages in the remaining three indicators. The practice had a programme of targeted quality improvement and used information about care and treatment to make improvements. We reviewed two of the practice's most recent clinical audits which showed an improvement in the management of people taking diazepam and those on hormone replacement therapy.