Cornerstone Family Practice

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• 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 a total of 3 quality statements from this key question. We have combined the scores for these areas with scores based on the rating from the last inspection, which was good. Our rating for this key question remains good. We found safety was a top priority, and staff took all concerns seriously. When things went wrong, staff acted to ensure people remained safe. 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. The practice reviewed and responded to complaints in a timely and professional manner.

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

The provider had processes for staff to report incidents, near misses and safety events. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning was shared amongst the clinical and wider practice team where appropriate.

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.

Feedback from people responding to the national GP survey reported difficulties using the service, however, 97% of people took the appointment that they were offered and 77% of people found the receptionists helpful. People felt involved in any assessment of their needs and felt confident that staff understood their individual and cultural needs.

There was a commitment to taking immediate action to keep people safe from abuse and neglect. Staff were aware of who the safeguarding lead was and the process for raising concerns. Staff told us they had received training in safeguarding children and adults. Staff reported knowing who the safeguarding lead was. There was a commitment to taking immediate action to keep people safe from abuse and neglect. This included working with partners collaboratively. We did not receive any concerns from commissioners or other system partners about safeguarding.

We did not receive any concerns from commissioners or other system partners about safeguarding.

There were effective systems, processes, and practices to make sure people were protected from abuse and neglect. Examples of this were that safeguarding was now a regular agenda item at the monthly clinical governance meeting and regular audits were being carried out. Staff checked that children and vulnerable adults who did not attend or were not brought to their scheduled appointment were followed up and highlighted to the partners. Staff had received safeguarding, chaperone, and Mental Capacity Act training relevant to their role.

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.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

CQC had not received any feedback from members of the public regarding this service. The evidence we reviewed did not show any concerns about people’s experience regarding safe and effective staffing arrangements. The provider had arrangements in place to allow patients the opportunity to provide feedback on the service received. The way they managed feedback showed the views of people were listened to and considered.

CQC had not received any feedback from members of the public regarding this service. The evidence we reviewed did not show any concerns about people’s experience regarding safe and effective staffing arrangements. The provider had arrangements in place to allow patients the opportunity to provide feedback on the service received. The way they managed feedback showed the views of people were listened to and considered.

Staff completed training appropriate and relevant to their role and were given time to complete the training. The provider had robust systems in place for monitoring the completion of training deemed mandatory. Staff received the support they needed to deliver safe care. This included appraisal and support where needed to develop, and improve services, and where needed, professional revalidation. A programme of audit to ensure clinical oversight of clinicians was in place. Systems were in place to manage poor performance.

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.

Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. 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. People were provided with information on their medicines and how to access to support. Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring, however the provider experienced some difficulties getting patients to attend for some of these tests and the theme of poor compliance of some of these patients with some medication. We were told that they would discuss these issues at their next practice meeting to brainstorm approaches to improve this.

Staff managed medicines safely and regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. 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. There was an appointed medicines management lead who conducted audits on their prescribing behaviours. One audit carried out was to address the potential missed diagnoses of CKD and diabetes to ensure patients were diagnosed where appropriate and could then receive the appropriate treatment and follow-up care.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment showed that the number of antimicrobials issued by the provider was higher than local and national averages. There was a programme of regular clinical auditing of prescribing that focused on improving care and treatment.