Manchester Road East Medical 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

We assessed all the quality statements for this key question. Our rating for this key question has improved from inadequate to good. We found improvements in safety concerns which were taken seriously. When things went wrong, staff acted to ensure people remained safe. Managers encouraged staff to report incidents and these were investigated and analysed to reduce the likelihood of them being repeated. Staff supported people to live healthy lives and provided them with support and information on their care and treatment. We saw an improved proactive and positive culture based on openness and honesty. We saw that lessons had been learned and were embedded into everyday practice.

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 were unable to speak to people directly. The practice carried out its own surveys and we reviewed the results from June and July which were positive. Results from the Friends and Family test were positive.

We saw that there was enough staff in place and that training was appropriate and up to date. Staff received induction, annual appraisal and clinical supervision. They were able to demonstrate safe systems, pathways and transitions were in place. Staff told us that the culture had improved and safety was a priority. We saw that safety events were reported and investigated and lessons were learned so that mistakes were not repeated. Incidents and complaints were reported and investigated and these were discussed at meetings. Risk assessments were carried out and updated. We were told that systems to assess, monitor and manage risks to patient safety were continually reviewed and we saw that staff understood the importance of this.

We found a positive learning culture. Staff knew how to identify and report concerns, safety incidents and near misses. The practice learned and made improvements when things went wrong, with a system in place to manage and act on significant events. However, in some cases, we saw the process was inconsistent and this could be improved further to prevent any near misses.

We were unable to speak to people directly. The practice carried out its own surveys and we reviewed the results from June and July which were positive. Results from the Friends and Family test were positive. There was a better process for listening and acting on behalf of patients and we saw that care and support was planned and organised with patients and partners.

Referrals to specialist services were appropriate and monitored and there was a documented approach to the management of test results. We also saw that appropriate systems were in place to manage prescribing for patients and medicines optimisation. The clinical searches revealed that recording and coding in the clinical system was appropriate and advice was given to patients on how to manage their conditions. Although we did not identify areas of clinical risk in any of the clinical records reviewed, the clinical searches did identify records where improvements could be made. The practice was responsive to feedback given as a direct result from our reviews. There was an improved awareness of the risks to people and an improved approach to identifying and managing those risks.

Feedback about the practice from the Local Medical Council (LMC) and the Integrated Care Board (ICB) was positive. The provider and the practice had engaged with the LMC to help them make the improvements required and the LMC reported that they were conscientious, caring and passionate and keen to improve. The ICB confirmed that the practice integrated well with the Primary Care Network from where they had also received support to make improvements and this continued at the time of the inspection.

We saw several policies and processes about safe working practices for referrals, tasks, discharges, prescribing and partnership working which had improved since the previous inspection and were reviewed and updated and embedded into everyday practice. Staff were aware of protocols and aligned their working practice accordingly. Staff were aware of policies and procedures such as the complaints process, incident reporting and meetings where these subjects were discussed.

We did not speak to people directly about safeguarding and there was no negative feedback received from patients prior to the inspection.

We saw that the practice worked with people to achieve the best outcomes regarding safeguarding. We saw an open culture where staff understood how to report and act on any safeguarding concerns. There were safeguarding registers which were updated and regular safeguarding meetings in the practice where vulnerable patients’ were monitored and discussed to ensure they were receiving the required care and treatment. Safeguarding policies and procedures were in place and we saw that staff were able to access them easily.

Feedback from partners was positive. We were told that the practice integrated well with other organisations such as the PCN and attended multidisciplinary meetings where people on safeguarding registers were discussed and their care was monitored. There was a shared care approach. We saw that there was duty of candour in place and that people’s human rights were protected.

Registers and meetings kept the practice up to date with any patients who required monitoring. Staff had been trained to appropriate levels and training was monitored to keep it up to date. The practice policy incorporated Salford Safeguarding Adults and Children and was up to date and reviewed. There was designated contact information easily available.

People knew what to do and who to contact when they realised that things might be at risk of going wrong or their health condition may be worsening. There were some negative comments in the Friends and Family Test which was the patient’s perspective of how they were dealt with on the day of their appointment.

Staff told us that patients were able to request home visits to meet their care needs. We saw that a new care navigation system was in place to direct people to the most appropriate services for their need.

We saw a care navigation system, evidence of staff training and evidence of staff using new ways to navigate patients to the right person, right place, right time. There was a process to manage urgent referrals which was improved from the previous inspection.

Improvements had been made since the previous inspection and we saw that leaders and staff considered how environments could keep people safe from psychological harm as well as physical harm. Quiet private spaces were offered if patients needed to speak privately with staff.

We saw improvements since the previous inspection and facilities, equipment and technology were well-maintained and consistently supported staff to deliver safe and effective care. Equipment used to deliver care and treatment was suitable for the intended purpose, stored securely and used properly. We pointed out areas for consideration and these were accepted by the manager.

We saw that improvements had been made following the previous inspection. Policies and procedures had been updated and the provider had appropriate infection control, health and safety, fire and premises risk assessments and action plans in place to keep the environment safe for people.

93% of people who responded to the most recent GP patient survey found the reception and administrative team at this GP practice helpful.

We saw that there was enough staff in place and training was appropriate and up to date. They received induction, annual appraisal and clinical supervision. Staff were able to demonstrate safe systems, pathways and transitions were in place. Referrals to specialist services were appropriate and monitored and there was a documented approach to the management of test results. We saw that appropriate systems were in place to manage prescribing for patients and medicines optimisation. The clinical searches revealed that recording and coding in the clinical system was appropriate and advice was given to patients on how to manage their conditions. The practice was responsive to feedback given as a direct result from our reviews.

Staff received training appropriate and relevant to their role. Recruitment checks were carried out in accordance with regulations (including for agency staff and locums). We saw very good clinical supervision that took place for all clinical staff on a regular basis.

There was no specific feedback from people about infection prevention and control.

Staff knew who the infection prevention and control lead for the practice was. They felt supported in understanding infection prevention and told us they received appropriate training, such as hand washing. Staff who handled clinical specimens knew how to do so safely.

The premises were clean, and equipment used was well maintained which helped to protect patients and visitors from the spread of infection. The chairs in the waiting room were wipeable, sufficient PPE and hand washing facilities were available in clinical areas. Clinical staff were observed as bare below the elbow as per guidelines.

There were clear roles and responsibilities around infection prevention and control. There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. The provider completed regular hand washing and infection control audits, the results of these were actioned to improve compliance.

People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms.

Leaders were all aware of their roles and responsibilities surrounding medicines management. The lead GP had oversight of medicines management at the practice. Leaders demonstrated through discussion that patients’ concerns had been listened to and improvements were being made. Clinical meetings were attended by clinical staff to discuss complaints, significant incidents, medical alerts and patient concerns. Staff received regular training on medicines management, and felt confident managing the storage, administration and recording of medicines.

Staff managed medicines safely and regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Staff showed how they disposed of expired medications. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. We pointed out an area for consideration and these were accepted by the manager.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff managed medicines-related stationery appropriately and securely. Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. Medicine reviews were well documented. However, dementia reviews would benefit from fuller detail.

The management of medical alerts had improved from the previous inspection and was now a well-managed process. There were meetings between nurses and pharmacists where audits and medical alerts were discussed and appropriate actions were taken. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics.