Dr Salam J Farhan Also known as Partington Central Surgery

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 the quality statements for this key question. Our rating for this key question has improved from inadequate to good. The provider was able to demonstrate that patients were safe and protected from avoidable harm. We found improvements in safety concerns which were taken seriously. When things went wrong, staff acted to ensure people remained safe. Managers encouraged staff to report incidents and these were investigated and analysed to reduce the likelihood of them being repeated. Staff supported people to live healthy lives and provided them with support and information on their care and treatment. We saw an improved proactive and positive culture based on openness and honesty. We saw that lessons had been learned and were embedded into everyday practice.

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 did not speak directly to people who used the service but received feedback through comments and enquiries. The practice carried out its own surveys and we reviewed the results from those which were positive. We saw feedback from two patients directly to a GP about positive interaction regarding their care. Results from the Friends and Family test were positive.

Staffing levels had now improved considerably and we spoke to staff who told us they were appropriately trained to undertake their roles. They said they received induction, annual appraisal and clinical supervision. They were able to demonstrate safe systems, pathways and transitions. Staff told us that the culture around safety had now improved and demonstrated this via minutes from meetings where safety was discussed as a priority. Risk assessments were carried out and updated. We were told that systems to assess, monitor and manage risks to patient safety were continually reviewed and we saw that staff understood the importance of this.

We found a positive learning culture. Staff knew how to identify and report concerns, safety incidents and near misses. The practice learned and made improvements when things went wrong, with systems in place to manage and act on significant events. Processes were now improved and were embedded and followed consistently. We saw that meetings were structured and included all members of staff.

We did not speak directly to people who used the service but received feedback through comments and enquiries. The practice carried out its own surveys and we reviewed the results from those which were positive. Results from the Friends and Family test were positive. There was a much improved process for listening and acting on behalf of patients and we saw that care and support was planned and organised with patients and partners.

Staff told us that referrals to specialist services were appropriately monitored and there was a documented approach to the management of test results. They demonstrated how those systems were used to manage prescribing for patients and medicines optimisation. Our clinical searches revealed that recording and coding in the clinical system was appropriate and advice was given to patients on how to manage their conditions. Although we did not identify areas of clinical risk around safe systems and pathways, the clinical searches did identify records where improvements could be made to record keeping and the practice was responsive to our feedback about this. The lead GP and other members of staff demonstrated during discussion that there was improved awareness of risks to people and an improved approach to identifying and managing those risks.

Partner organisations reported improved relationships with the practice since the previous inspection. There were regular improvement meetings between the practice and the Integrated Care Board and additional practice manager support had been provided by the Primary Care Network.

We saw that the provider had improved policies and processes for referrals, prescribing and partnership working since the previous inspection. Staff were aware of and worked in line with policies and procedures such as the complaints process, incident reporting and meetings where these subjects were discussed.

We did not speak directly to people who used the service about safeguarding. However, we reviewed negative safeguarding concerns received from patients prior to the inspection and took those into account when assessing safeguarding at the practice.

During discussions with staff and leaders they told us how the practice worked with people to achieve the best outcomes regarding safeguarding. We saw an improved, open culture where staff understood how to report and act on any safeguarding concerns. Staff told us that safeguarding information was discussed at meetings and this gave them a better understanding of any patients who may be at risk.

Feedback of concern received from partners was reviewed as part of this assessment. We saw that the practice had much improved communications with partner organisations such as the Primary Care Network (PCN) and attended multidisciplinary meetings where people on safeguarding registers were discussed and their care was monitored. Partners told us there was a shared care approach and duty of candour in place and that people’s human rights were protected.

The practice had an up to date register and regular meetings to monitor any patients under safeguarding arrangements. Staff had been trained to appropriate levels and training was monitored to keep it up to date. The practice policy incorporated local Safeguarding Adults and Children and was up to date and reviewed. Information about who to contact in the safeguarding team was clear.

Staff gave people clear guidance and advice so they knew what to do and who to contact when they realised they may require help if their health condition may be worsening.

Staff told us that patients were able to request home visits to meet their care needs. We saw that an improved care navigation system was in place to direct people to the most appropriate services for their need.

There was a care-navigation system in place, evidence of staff training and evidence of staff using new ways to navigate patients to the right person, right place, right time. There was a process to manage urgent referrals which was improved from the previous inspection. There was a process to safety net patients and a new patient feedback form for patients to raise any concerns that may lead to a potential risk.

Leaders told us about many improvements that had been made since the previous inspection and we saw that leaders and staff considered how the practice environment could keep people safe from psychological harm as well as physical harm. Quiet private spaces were offered if patients asked to speak privately with staff and further improvements to the premises were being made so that people could address health care needs such as weight and blood pressure at the surgery.

We saw improvements since the previous inspection. Facilities, equipment and technology were now well-maintained and consistently supported staff to deliver safe and effective care. Equipment used to deliver care and treatment was suitable for the intended purpose, stored securely and used properly.

We saw that improvements had been made since the previous inspection. Policies and procedures had been updated and the provider had appropriate infection control, health and safety, fire and premises risk assessments and action plans in place to keep the environment safe for people. There was appropriate communication and relationships between the practice and building managers. However, the practice was limited in the improvements it was allowed to make.

72% of people who responded to the most recent GP patient survey found the reception and administrative team at this GP practice helpful. This was less than the national average of 83% and less than the response at two neighbouring practices. The practice were responding to this result by training reception staff in customer care and care navigation.

Staff and leaders told us that there was enough staff in place and training was appropriate and up to date. Staff told us they received induction, annual appraisal and clinical supervision. Leaders were able to demonstrate safe systems, pathways and transitions were in place. Leaders and staff told us how they undertook referrals to specialist services and demonstrated a documented approach to the management of test results. The clinical searches revealed that recording and coding in the clinical system was appropriate and staff told us how they gave advice to patients on how to manage their conditions.

Staff received training appropriate and relevant to their role. Recruitment checks were conducted in accordance with regulations (including for agency staff and locums). We saw very good clinical supervision in place for all clinical staff on a regular basis. We saw that appropriate systems were now in place to manage prescribing for patients and medicines optimisation.

There was no specific feedback from people about infection prevention and control.

Staff knew who the infection prevention and control lead for the practice was. They said they felt supported in understanding infection prevention and told us they received appropriate training, such as hand washing. Staff who managed clinical specimens knew how to do so safely.

The premises were clean, and equipment was well maintained which helped to protect patients and visitors from the spread of infection. The chairs in the waiting room were wipeable, sufficient PPE and hand washing facilities were available in clinical areas. Clinical staff were observed as bare below the elbow as per guidelines.

There were clear roles and responsibilities around infection prevention and control. There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. The provider completed regular hand washing and infection control audits, any and improvements were made following these to improve compliance. The score from the most recent IPC audit (2024) undertaken by Trafford Council was 94%. The concerns identified were not directly the responsibility of the practice and were communicated to the landlord to rectify.

People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms.

We were told by staff and leaders how they were all aware of their roles and responsibilities surrounding medicines management. The lead GP had oversight of medicines management at the practice. We spoke to members of staff including a new salaried GP and clinical pharmacist who told us how they communicated with leaders and other staff through meetings, about the management of patients’ medicines. Clinical meetings were attended by clinical staff to discuss complaints, significant incidents, medical alerts and any other patient concerns. Staff told us they received regular training on medicines management, and felt confident managing the storage, administration and recording of medicines.

We saw how staff managed medicines safely and regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Staff showed how they disposed of expired medications. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. We did not find any considerable safety concerns from the remote clinical searches. However, during our review of patients on methotrexate and direct oral anticoagulant medicine (DOAC) we highlighted areas for improvement.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff managed medicines-related stationery appropriately and securely. Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. Medicine reviews were well documented.

Management of safety alerts had improved from the previous inspection and was now well-managed. There were meetings between nurses and pharmacists where audits and medical alerts were discussed and appropriate actions were taken. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. However, we found patients taking teratogenic medicines (these are medicines which could affect a foetus or child development) were not always robustly advised of the risks of getting pregnant.