Crofton and Sharlston 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 looked for evidence that people were protected from abuse and avoidable harm. At our last inspection, we rated this question as requires improvement. At this assessment, the rating has changed, and we have now rated the practice good. The practice had a positive learning culture and staff could raise concerns. Staff understood risks and shared examples of managing or mitigating risk. There were enough staff with the right skills, qualifications and experience. Staff managed medicines well and involved people in planning any changes.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice had policies and systems in place to manage significant events, incidents and complaints. The practice ensured that incidents and complaints were appropriately investigated, reported and discussed within meetings. Leaders told us that they were promoting a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and staff knew how to escalate their concerns and could confidently signpost patients on how to raise any concerns or queries appropriately.

The practice worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services and had policies and systems in place to manage summarising, referrals, workflow, pathology and blood tests.

The practice had a safeguarding lead and deputy for both adults and children, and a safeguarding handbook covering both adults and children. We saw confirmation that staff had received the training in line with the intercollegiate guidance for safeguarding adults and children. Staff knew who the lead was, how to access the handbook and felt able to escalate concerns. The practice held regular safeguarding meetings and a reviewed sample of records within the clinical notes review found appropriate flagging of vulnerable children and adults. There was a policy for chaperoning and staff had undertaken training as required. There were posters prominently displayed in patient areas at both practice sites.

The practice had policies and systems in place for medical emergencies and we saw processes were in place for the management of emergency equipment and medicines at both sites. We found gaps in staff training, and not all staff had a record of training for up-to-date basic life support, cardiopulmonary resuscitation (CPR) or sepsis awareness training. Staff were aware of how to raise an alarm in the event of an emergency and staff could also use the panic alarm system integrated into their clinical system. Staff were aware of the location of the emergency medicines and medical equipment, for example oxygen and the automated external defibrillator (AED).

The facilities and premises were appropriate for the services being delivered. At our on-site assessment we observed the premises to be clean, accessible and appropriate for the activities being carried out. We reviewed the premises and facilities documentation for both sites and found that the practice did not always have oversight of the upkeep of the premises undertaken by the landlord and did not have up-to-date actions plans. The practice had been working on ways to improve this to ensure that tracking and oversight of maintenance is completed in a timely manner.

The practice had policies and systems in place for recruitment, induction and training. We reviewed some staff records and found that the practice did not always ensure that they obtained the correct pre-employment documentation, such as references and immunisation status. Although the practice was able to provide these documents after the assessment, we found they had not consistently followed their processes for recruitment. We found that some staff were not up to date with mandatory training. During the assessment, the practice acted, enabling staff to undertake the necessary training and where this was not possible, provided assurances that this would be completed as a priority.

The practice had a designated infection, prevention and control (IPC) lead and staff had received training relevant to their role. The practice had a handbook that was accessible to staff and there were risk assessments and audits completed with actions taken to mitigate risk. Both sites for the practice had waste segregation and management systems in place and had cleaning schedules, as well as external cleaners.

The practice had policies and systems in place to check the stock levels of equipment and medicines, they also checked the expiry dates for medicines, including the emergency medicines, the doctor home visit boxes and vaccines . The practice had effective systems to manage and respond to safety alerts and medicine recalls, they involved patients in the reviews of their medicines and helped them to manage medicines safely. As part of our assessment, a Care Quality Commission GP specialist advisor (SpA) conducted a series of remote clinical searches of patient records. We found no concerns with the practice’s procedures and saw that the practice followed established processes to ensure patients prescribed medicines with specific risks, received recommended monitoring.