Square Health

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Medicines optimisation

We assessed 1 quality statement in the safe key question and found some areas of concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Although the assessment indicated some areas of concern since the last inspection, our rating for the key question remains good. Our findings at this assessment were: There was a lack of documented evidence of regular discussions relating to specific safeguarding cases. We found limited evidence of learning being identified, discussed and shared with relevant staff groups. An internal safeguarding tracker included insufficient detail to demonstrate actions taken, learning outcomes and changes implemented as a result. We identified some missed opportunities for sharing learning and delays in sharing learning across the whole organisation. There was a lack of clarity within policies around required levels of adult and child safeguarding training required for clinical and non-clinical staff. The provider was able to access support and advice from level 4 trained individuals in relation to their NHS services. We found some evidence of clinical audits which included the monitoring of safeguarding processes. We identified examples of poor quality-control of documents and inaccurate record keeping. Policy content did not always include clear or relevant information. Leaders within the service were unable to demonstrate that robust governance procedures were consistently implemented.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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

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.

We spoke with 20 staff and leaders as part of this assessment and we received 34 responses to our staff questionnaire. Clinical staff appeared knowledgeable and confident in the role they played in implementing safeguarding processes. Staff were happy with the level of support they received in raising safeguarding concerns. However, we identified a lack of understanding, in some instances, of non-clinical staff, of the difference between internal safeguarding processes and external referral to a local safeguarding team.

Safeguarding concerns and referrals were monitored via the provider’s internal safeguarding tracker and NHS reporting system. We found insufficient detail on the internal tracker to demonstrate actions taken, learning outcomes and changes implemented. We identified some missed opportunities and delays in sharing learning across the organisation. For example, where staff had not followed organisational process in managing concerns about a patient. We saw one example of a review of safeguarding cases within a GP peer group meeting. Otherwise, there was limited evidence of learning being identified, discussed and shared with relevant staff groups. There was a lack of clarity within policies around required levels of adult and child safeguarding training. Leaders took prompt action to ensure safeguarding training was completed in line with national guidance during our assessment, for staff who had not completed the appropriate level of training. Safeguarding policies did not include some content we would expect to see. For example, there was no guidance for staff on how to access safeguarding support when working out of hours. Policy content did not always include clear or relevant guidance for staff. For example, the provider’s policies failed to clearly set out their approach to undertaking Disclosure and Barring Service checks. Safeguarding policies included unclear process appendices and inconsistent use of terminology, which may cause confusion for staff. We found some evidence of clinical audits which included monitoring of safeguarding processes. We saw where auditing of GP consultation records identified a missed opportunity to explore a potential safeguarding concern, feedback was provided promptly to the clinician. We saw a review of consultations, where 3 children had been identified as having multiple appointments within a 6-month period.

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.

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

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