Horizon Health Centre Also known as (within) For All Healthy Living Centre

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 the safe key question. Our rating for this key question is now good. There were systems in place to assess, monitor and manage risks to patient safety. The service regularly reviewed, analysed, and learnt from events and incidents. The service had clear systems, practices, and processes to keep people safe and safeguarded from abuse. The service had systems for the appropriate and safe use of medicines which required additional monitoring. Staff were knowledgeable within their role and shared experiences to support development.

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 received no specific feedback in this area.

3 – Staff were aware of their responsibilities and knew how to identify and report concerns and safety incidents. They attended regular meetings where learning was shared. Staff told us leaders were approachable and supportive. Leaders demonstrated they managed significant events and complaints appropriately and staff were involved in identifying any learning.

Policies and procedures were in place to support and encourage a learning culture. There was a process to record and review significant incidents and complaints. The service learned and made improvements when things went wrong. Feedback and learning was shared in staff meetings. We saw evidence of this learning being shared with staff.

We received no specific feedback in this area.

Staff were able to tell us about the systems in place supporting the delivery of safe care and treatment . Staff knew the importance of continuity of care to ensure the right care at the right time. Staff and leaders were aware of the importance of safe systems and pathways to deliver quality care.

Partners told us the service worked well with other health and care professionals. The service actively participated in regular meetings made up of representatives from different professional and community bodies such as the local authority, housing, and the police to ensure a joined-up approach in supporting people.

There were appropriate referral pathways to make sure that peoples’ needs were addressed. There was a system for processing information relating to new patients including the summarising of new patient notes. Referrals to specialist services were documented, contained the required information and there was a system to monitor delays in referrals.

We received no specific feedback in this area.

Staff had completed training in safeguarding to an appropriate level for their role and could identify vulnerable people easily. They were aware of the systems and processes the service had to keep people safe and safeguarded from abuse and felt confident in raising concerns. Staff knew who the safeguarding leads were.

Partners did not raise any concerns regarding safeguarding at the service.

Safeguarding systems, processes and practices were developed, implemented, and communicated to staff. The Out of Hours service was informed of relevant safeguarding information. There were regular discussions between the service and other health and social care professionals such as health visitors, social workers and police to support and protect adults and children at risk of significant harm.

We received no specific feedback in this area.

People’s needs were discussed during consultations. Staff informed people about risks and documented this on their patient record. Staff were aware of the importance of including people in decision making. Leaders told us they had implemented new systems and processes and shared them with staff.

There were adequate systems to assess, monitor and manage risks to patient safety. These had been shared with staff. Appropriately trained staff completed consultations and provided specific advice to people. Risks were recorded on patient records.

Staff were aware of their responsibilities to ensure the environment was safe for people such as their role in responding to an emergency. Staff had completed appropriate training including fire safety and information governance. Staff told us space at the premises was limited however, it did not have an impact on service delivery for the practice population.

The facilities and premises were appropriate for the services being delivered. Equipment was fit for purpose and was in good working order. Environmental risks had been assessed and where necessary, appropriate actions taken. There was clear signage around the building in the event of an emergency evacuation.

The service had made reasonable adjustments when people found it hard to access services such as level access to the building. Health and safety risk assessments had been carried out and appropriate actions had been taken. We saw safe systems and processes were in place to support a safe environment.

We received no specific feedback in this area.

Staff told us there were enough staff to provide a safe service. Some staff felt there should be more face-to-face appointments with GPs as some GPs employed only carried out remote consultations. Leaders were aware of safe staffing levels and responding appropriately to meet demand.

The service was able demonstrate staff had the skills, knowledge, and experience to carry out their roles. There was a system in place that demonstrated appointments were allocated to appropriate clinicians. Staff had completed mandatory training, and this was centrally monitored to ensure timely completion. Some staff had also completed specific training in their specialist area. Staff were supported to meet the requirements of professional revalidation. There was an ongoing recruitment advert to attract new staff to the service.

We received no specific feedback in this area.

Staff were aware of their infection prevention and control (IPC) responsibilities for example, how to respond to an outbreak. Staff were able to name the IPC leads. Staff told us they could raise IPC concerns in team meetings. Staff knew how to manage clinical waste and specimens.

Appropriate standards of cleanliness and hygiene were met. The premises were visually clean and hygienic. There were arrangements in place for managing waste and clinical specimens. Sharps bins were appropriately managed. Staff had access to PPE.

Staff had received effective training on infection prevention and control. Policies and procedures were available to staff. An up-to-date infection prevention and control audit had been carried out and an action plan had been completed. A process was in place to record, and risk assess staff vaccinations in line with national guidance.

We did not receive enough specific feedback in this area to rescore this evidence category

Staff told us that they involved people in decisions about their medicines during reviews and assessments. They were able to describe the systems to identify people who required monitoring based on the medicines they were prescribed. Staff and leaders had a good knowledge of their patient population. Non-medical prescribers (healthcare professionals who can prescribe medicines but are not GPs) were able to discuss their prescribing each day if needed with an onsite GP or prescribing nurse.

Clinical records were kept accurate and up-to-date. Emergency medicines were stored securely and checked regularly. Vaccines were appropriately stored and monitored in line with guidelines. Blank prescriptions were kept securely, and their use was adequately monitored. Appropriate authorisations for staff to administer medicines were in place including Patient Group Directions (a written instruction for the supply and/or administration of a named licensed medicine for a defined clinical condition) or Patient Specific Directions (a written instruction from a doctor or other independent prescriber for a medicine to be supplied or administered to a named patient).

Systems and processes were in place to ensure the appropriate and safe use of medicines. Our remote clinical searches identified a process for monitoring people’s health in relation to the use of medicines including medicines that require frequent monitoring (for example, warfarin, methotrexate, and lithium). Appropriate monitoring and clinical reviews were taking place prior to prescribing. Our clinical searches identified 486 people had received a medicines review in the previous 3 months. We reviewed 5 of these patient records and did not identify any concerns. The service had a process for reviewing the prescribing competence of non-medical prescribers, and their prescribing practice was regularly reviewed and supported by the clinical lead. The service had a system for recording and acting on safety alerts.

We reviewed prescribing data which indicated the prescribing of some medicines was above the local and national expectations. Pregabalin or Gabapentin (medicines prescribed for treatment of epilepsy, neuropathic pain, or generalised anxiety disorder) were being prescribed at a higher rate than expected. The service was aware of this and carried out a regular audit for people being prescribed these medicines to reduce their use. The audit reviewed if prescribing was appropriate, if it was safe and if a follow up had been arranged with the individual. The service had appointed leads in various clinical areas to ensure effective oversight and provide regular updates to clinical staff regarding patient outcomes following changes in clinical care. Any issues with prescribing would be flagged with the lead clinician.