Werrington Village 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 looked for evidence that people were protected from abuse and avoidable harm. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 72 (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. Representatives from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service.

The provider listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical issues.

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 from incidents and complaints resulted in changes that improved care for others.

People fed back that they felt happy with the clinical care they received. Results from the national patient survey demonstrated that 85% say the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment and 78% say the healthcare professional they saw or spoke to was good at considering their mental wellbeing during their last general practice appointment.

The service worked with people and healthcare partners including district nurses, social workers and palliative care nurses 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.

The partners told us that they had a strategy in place to train more staff and build resilience into their back-office systems, and that there is a strategy of reviewing referrals and test result by risk priority rather than in date order to ensure nothing requiring a time bound review is missed.

The service worked with people and healthcare partners including district nurses, social workers and palliative care nurses 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.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Results from the national patient survey demonstrated that 85% say the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment

The practice concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Staff told us they had access to their safeguarding policy, were trained to the appropriate level in accordance with their role and demonstrated a clear understanding of safeguarding. They knew who the designated safeguarding lead was and the service shared concerns quickly and appropriately.

Partners gave us examples of how a case had gone through there safeguarding process, and how there is resilience in the process if the safeguarding lead was not available. Partners confirmed that they hold multidisciplinary safeguarding conferences as appropriate.

Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. The provider confirmed that social services regularly gave them feedback on any safeguarding referrals about their patients.

The service provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. We saw evidence that when patients reported issues this was investigated via their significant event process and action was taken.

Leaders had a clear strategy to ensure resilience in their staffing of teams, due to unprecedented recent situations, there had been occasions when the surgery had run short staffed. Staff were not always aware of the future plans and strategies to resolve these issues. Staff could recognise a deteriorating patient and knew of action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

Emergency equipment was available and maintained, including a mobile screen to protect patients’ dignity if they collapse in a communal area.

Staff had completed training around health and safety arrangements, including fire safety, and basic life support. Staff were all aware of their overall responsibilities for ensuring a safe environment at the practice. However, in the office areas there were some concerns around the facilities including office chairs meeting health and safety workstation regulations.

The service ensured that appropriate health and safety risk assessments were in place. However, at the time of the inspection the fire risk assessment had not been completed within an appropriate timeframe. We saw evidence that this had been resolved immediately following the inspection. We observed that building security needed to be reviewed.

Contracts were in place to ensure the premises were maintained; however, the fire risk assessment was out of date at the time of the inspection but was resolved immediately following the site visit? Health and safety risk assessments and audits had been undertaken. However, in non-clinical areas risks had not always been addressed. There was a business continuity plan in place which was monitored and reviewed.

The service had enough qualified and skilled and experienced staff who received effective support, supervision and development to provide safe care that met people’s individual needs.

There were a range of clinical and non-clinical roles within the practice. We found training was up to date, learning needs and development of staff was managed appropriately, and staff told us if they request any further appropriate training this was supported, and staff were working within their agreed areas of competence. Many staff at the practice had worked at the surgery a long time, and the teams were supportive of each other. Due to recent unforeseen issues, there had been low numbers of staff, but management stepped in to support if it was needed. Two staff were non-medical prescribers, and the on-call doctor had an open-door policy and supported with daily issues, prescribing audits had been completed for both staff members.

Safe recruitment practices were followed.

We did not receive any feedback about people’s experiences in relation to infection, prevention and control (IPC).

Staff knew their responsibilities around infection, prevention and control and followed them appropriately. They were able to advise of the designated IPC practice lead and had no concerns in relation to the cleanliness of the practice. The practice manager held a copy of the latest audit undertaken on15 May 2024, and the practice had completed remedial actions. For example, a deep clean had been undertaken for visible dust to surfaces.

The practice had a designated infection, prevention and control lead and all staff had had relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed including hand hygiene and aseptic technique audits, and actions taken to mitigate risks. However, in one of the clinician's offices there was a chair that was not wipe down, this was resolved immediately following the inspection.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

We did not receive any feedback around people’s experiences in relation to Medicine management. The surgery patient survey results demonstrated that 94% of patients stated that during their last GP appointment they were involved as much as they wanted to be in decisions about their care and treatment and 76% of patients told us they have had enough support from local services or organisations in the last 12 months to help manage their long-term conditions or illnesses.

Staff received regular training, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely. Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received medicines reviews and monitoring.

Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. Waste medicines were recorded and disposed of appropriately including medicines returned by patients. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments.

The process for managing safety alerts, specifically alerts from Medicines and Healthcare products Regulatory Agency (MHRA) were not always effective. For example, our clinical searches identified 143 patients on Sodium-glucose co-transporter-2 inhibitors or SGLT-2 inhibitors (medication used to manage blood sugar levels) who required review as ketoacidosis advice and Fournier's gangrene had not been recorded. We found that patients received medicines reviews and monitoring, however some of these reviews were overdue. For example, 4 out of 5 patients prescribed gabapentin were overdue a medicines review, and 4 out of 5 patients with hyperthyroidism had not had a thyroid function test during the last 18 months. We discussed this further with the provider who took action and sent us information following the inspection to show this had been completed.

The provider had systems to manage and respond to safety alerts and medicine recalls, however we found that this needed strengthening to ensure people prescribed medicines with specific risks received recommended monitoring and guidance. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued by the provider was lower than local and national averages. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.