Meon Health 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

Staff promoted a culture of collaborative working with safety central to decisions. Staff told us they were supported and encouraged to ask questions and report concerns. We found concerns were investigated, findings informed changes and improved patient services. People were supported by trained staff who provided information and support to assist them to make choices.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff knew how to raise concerns and told us they were supported to do so. They believed leaders and colleagues were committed to investigating, resolving and learning from incidents. Where improvements were required, information, advice and guidance was shared amongst staff to improve the safety and standards of care.

There were established and effective formal and informal systems in place to capture concerns from patients, staff, and partner services. Staff were trained in identifying and reporting concerns and had designated lead should they wish to speak with someone directly. Incidents and complaints were investigated in a timely and appropriate manner and where appropriate lessons learnt and shared to improve the service.

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.

Staff were trained in safeguarding and received additional awareness training during staff meetings. They understood, applied and adhered to Gillick competency (is often used to assess whether a child is mature enough to consent to treatment), Fraser guidelines (used specifically for children requesting contraceptive or sexual health advice and treatment) and the Mental Capacity Act. Staff had access to adult and children safeguarding leads within the practice and could also escalate concerns externally if required. Staff told us they worked regularly and collaboratively with partner health and social care service coordinate services to support and met individual’s needs.

People told us staff actively engage and contribute to collaborative working. We reviewed safeguarding meeting minutes and found that a range of staff had made appropriate referrals to the safeguarding team. The practice was also active within their Integrated Care Board (ICB) attending and contributing to quarterly meetings to review Quality and safety process.

The practice had established and effective systems in place to safeguarding vulnerable adults and children. Records of vulnerable people were regular revised to ensure information was current and relevant. We saw children had been appropriately followed up with when they failed to attend appointments with primary and or secondary care services. This was overseen by an appointed safeguarding lead who contributed to multidisciplinary meetings. We checked a sample of do not attempt resuscitation records for patients and found appropriate safeguards had been observed.

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.

People told us they had undertaken annual training in health and safety and practices procedures. Staff had been trained in emergency first aid. Staff could alert colleagues to concerns such as verbal or physical abuse via their clinical system whilst providing care or support to patients and this was regularly tested. Staff told us they had used it and found it to be effective.

We found there was assisted entry into the practices via a ramp, doors. People had access to chairs with arms in the waiting areas to assist those with limited mobility. There were appropriate child changing facilities with appropriate restraint belt to mitigate the risk of the child falling whilst being changed. Health and safety posters were displayed in the staff only areas with contacts of who to escalate concerns to. Clinical staff used single use items and had access to body fluid spillage kits to mitigate the risk of infection to patients. We saw fire safety wardens were on duty at each practice site and all staff were aware of evacuation procedures and had rehearsed them. Information was displayed throughout the practices and on their website promoting dignity and respect to people and the standards of conduct expected.

There were established and effective systems in place to identify, manage and mitigate risks to people. For example; the practice had conducted environmental risk assessments (including legionella testing and portable appliance testing) to ensure staff and people were safe and revised them annually or more frequently in response to changes. Staff also conducted daily inspections of each practice site to ensure risks were identified, recorded and addressed. These were overseen and regularly revisited by the practice manager and the management team who were updated on their progress and resolution. Maintenance contracts were in placed to maintain the accuracy of equipment (calibration), scheduled safety checks were conducted on the fire alarm system, emergency lighting and equipment. Staff had been Disclosure and Barring checked (a way for employers check your criminal record, to help decide whether you are a suitable person to work for them) or risk assessed.

Staff and leaders understood the recruitment, disciplinary and capability processes and believed they were fair. The management team ensured they were applied appropriately to ensure there is no disadvantage based on any specific protected equality characteristic. Staff told us appropriate staffing levels and skill mix was maintained to make sure people received consistently safe, good quality care that met their needs. Staff told us they found supervisions supportive and had professional development opportunities.

We found safe recruitment practices were employed when appointing clinical and non-clinical staff, including agency staff. Staff had suitable experience or were supported and assessed as competent to carry out their role. Staff were required to complete mandatory training and had opportunities to complete further training relevant to their role. Staff performance and conduct was monitored, and poor performance was addressed. This was achieved through supervision, appraisal and support to develop, improve services and where needed such as ensuring clinical staff maintained their professional revalidation. Thereby, providing greater assurance to patients and the public, employers and other healthcare professionals that licensed clinicians are up-to-date and fit to practise.

Staff told us they had been appropriately vaccinated to mitigate the risk to them and others of infection. They received training in infection prevention control and additional refresher information. They had access to barrier controls and gloves, apron’s and masks to mitigate the risk of infection to people. Staff explained to us how they triaged and managed patients with potentially contagious diseases.

We inspected all three locations and found they were clean and tidy. The reception desk was high and had clear screens to mitigate risks of infection to staff. Daily, weekly and monthly cleaning schedules were in place for rooms and equipment and had been appropriately completed. We found all handwash dispensers were full and there were appropriate hand drying arrangements in place. Additional checks were conducted by the management team to ensure standards for cleanliness were maintained. We checked cleaning cupboards and found all cleaning items had appropriate processes in place to control substances hazardous to people’s health.

There were established and effective systems in place for identifying, assessing and managing the risk of infection, which is in line with current relevant national guidance. Staff had appropriate vaccinations and receiving training and support to understand and adhere to policies and procedures promoting safe working practices. The lead nurse conducted an annual infection prevention control audit and produced an annual statement.

A lead GP oversaw the management of medicines within the practice to ensure safe prescribing practices. Best practice and guidance were shared with staff during clinical meetings to promote best practice. Staff monitored the collection of prescriptions. They alerted clinicians if prescriptions were not collected and a person may be vulnerable, such as dependant on their medication.

Medicines were stored appropriately in accordance with cold chain procedures to maintain their integrity. We found up-to-date information about people’s medicines was available, particularly when they move between health and care settings. People were involved with assessments and reviews about the level of support they need to manage their medicines safely and to make sure their preferences are included. Patient reviews were up to date, and we found regular appointments were scheduled with patients with long term conditions to monitor their conditions. People were signposted to additional support services to help them with their condition e.g. dietary or smoking cessation.

We found up-to-date information about people’s medicines was available, particularly when they move between health and care settings. There were established and effective systems in place to periodically search prescribing practices to identify potential risks to patients. Patient reviews were up to date and high risk medicines were effectively monitored. Medicines and Healthcare products Regulatory Agency alerts (providing alerts, recalls and safety information on drugs and medical devices) were reviewed and actioned. Clinical templates were utilised by staff to improve the quality of the clinical assessment, inform safe practice and alert them to potential considerations. Systems were in place to ensure the timely and appropriate collection of prescriptions.

We found people had been prescribed and safely monitored on their medicines. However, our searches of the practices clinical system identified inconsistencies with best practice guidance being followed for all people with long term health conditions. We shared our findings with the practice who reviewed the peoples care and treatment and mitigated any potential risks to them.