Dr Samir Sadik

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 quality statements in this key question. At our last inspection the practice was rated inadequate in safe. This was because: - • The provider did not offer care in a way that kept patients safe and protected them from avoidable harm. • Safeguarding was not given sufficient priority and staff were not suitably trained. • Staff had not undertaking mandatory training. • Risk assessments were not undertaken. • The arrangements for managing medicines did not always keep people safe. • Significant events were not discussed, shared and learned from. • The provider did not assess, monitor and improve staff capacity to ensure it was sufficient and safe to meet the needs of the service. During this assessment, we found all the required improvements had been made. Our rating for this key question is good overall. Managers investigated all reported incidents to reduce the likelihood of them happening again. Staff supported people to live healthy lives and provided them with support and information on their care and treatment.

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.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. Representatives from the PPG felt the provider took concerns seriously and proactively made improvements to the service.

Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical issues. Staff felt there was an open culture, and that safety was a top priority.

The provider monitored and reviewed safety using information from a variety of sources. There was a system for recording and acting on significant events. One of the incidents we reviewed had been investigated and learning shared as appropriate. Staff told us they knew how to report significant events. The other incident recorded did not have a date so we could not be sure when it occurred.

People had no specific feedback on this area.

Managers and staff could explain how people moved between services. Staff understood their responsibilities for monitoring the progress of referrals.

Partners had no specific feedback on this area.

When people moved between services, there was a plan in place for what happened next, who would do what and all the practical arrangements were in place. All Shared care requests were adhered to in conjunction with approved Greater Manchester Medicines Management Group (GMMMG) approved shared care protocols. Shared care is a particular form of the transfer of clinical responsibility from a hospital or specialist service to general practice in which prescribing by the GP, or other primary care prescriber, is supported by a shared care agreement.

People felt safe and supported to understand and manage any risks.

There was a strong understanding from staff and leaders of safeguarding and how to take appropriate action. During staff meetings, the whole team discussed any safeguarding concerns.

Partners had no specific feedback on this area.

There were effective systems, processes and practices to make sure people were protected from abuse and neglect within the practice. Some staff where not clear who the lead for safeguarding was, but due to the leadership working closely together, if concerns were shared with a leader or manager who was not the named lead, it was escalated appropriately. The partners attended a safeguarding meeting to discuss individual cases, they planned to build on these relationships and re-establish a multi-disciplinary meeting to discuss safeguarding with local services in the area.

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.

Managers told us that patients were able to request home visits to meet their care needs.

It was not clear what process were in place should a person call the practice severely unwell. We raised this with leaders who then put in place a signposting advice sheet to support staff. The provider assured us they had spoken with staff and the staff demonstrated they knew where to signpost people in an emergency.

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 asked to speak privately with staff.

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.

The provider had appropriate health and safety, fire and premises risk assessments and action plans in place to keep the environment safe for people.

People felt they had considerate support delivered by competent people.

Staff and leaders told us staff received the support they needed to deliver safe care. This included supervision, appraisal and support to develop, improve services and where needed, professional revalidation.

Staff received training appropriate and relevant to their role. Recruitment checks were carried out in accordance with regulations (including for agency staff and locums).

People had no specific feedback on this area.

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.

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.

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. However, some medicine reviews were not detailed enough, they did not include all medications and had not ensured that annual reviews or monitoring were up to date.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed confirmed this. For example, the number of antimicrobials issued by the provider was lower than local and national averages. However, people were prescribed higher than average amounts of Pregabalin or Gabapentin. We asked the provider to review patients with these prescriptions, the provider took appropriate action during the assessment period.