Evergreen Practice

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 2 quality statements in the safe key question and found improvements had been made since our last assessment. The scores for these areas have been combined with scores based on the rating from the last assessment and our rating for the key question remains good. We found processes to manage medicines safety alerts from the Medicines and Healthcare products Regulatory Agency (MHRA) were now clear and were followed by staff. Systems and processes to manage significant event activity (SEA) now ensured incidents were investigated and learning was shared with staff. Decisions about the stock of Emergency medical equipment used by the practice had now been risk assessed against guidance. Staff that were not qualified prescribers were now authorised to administer medicines correctly.

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 asked the provider to place a link on their website to the Give Feedback on Care process so we could hear of patients’ experiences of care and although this was done we did not receive any feedback from patients during the assessment period. The only feedback received in the months between this assessment and the last did not relate to this quality statement. At the last assessment we spoke with a member of the Patient Participation Group and they raised no concerns relevant to this quality statement and reported the practice always listened to their feedback.

Staff were now confident about significant event activity (SEA) processes and confirmed learning from SEAs was shared with them. Leadership and management encouraged a culture of learning from incidents. Staff provided examples of learning from recent significant events and told us safety was a priority within the practice.

The practice now had effective processes to manage significant events. These included systems to report and record events which ensured incidents were investigated. Systems now ensured learning from incidents was shared throughout the practice. Systems also existed to ensure that when things went wrong, patients were told, received an apology and if appropriate, the incident was reported to statutory bodies.

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

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 Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We asked the provider to place a link on their website to the Give Feedback on Care process so we could hear of patients’ experiences of care and although this was done we did not receive any feedback from patients during the assessment period. Feedback received in the months between this assessment and the last did not relate to this quality statement. We spoke with a member of the Patient Participation Group (PPG) during our last assessment and they reported the prescription request process worked well when they had used it.

Staff were now clear about how to manage and respond to safety alerts and medicine recalls. Staff we spoke with were clear of their responsibilities in the process. Staff in specialist roles had completed advanced training and told us this allowed them to take a holistic view of the patient’s entire health when advising the GP of required changes to the patients prescribing.

Processes to manage medicines safely were followed by staff. This included secure storage of medicines and monitoring stock levels, expiration dates and temperatures. Prescription stationary was stored securely when not in use.

The provider now had effective systems to manage and respond to safety alerts and medicines recalls. The practice had now risk assessed the decision to continue using a piece of emergency equipment which was not specifically suitable for children under the age of 8 years old against national guidance and had now shared guidance with staff about how to use the device. Staff that operated under Patient Group Directions (PGDs) to administer medicines were now authorised correctly. PGDs are used to authorise staff that are not qualified to prescribe to administer medicines to patients. The practice had clear processes to manage medicines safely, including monitoring the cold chain, expiration dates and stock levels of medicines.

Staff prescribed medicines appropriately to optimise care outcomes. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued for the provider was below the local and national averages. We also found no variation between the practice and local and national averages when we reviewed the prescribing of hypnotic and psychotropic medicines.