Consett Medical 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 looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating remains the same.

The service was in breach of legal regulation in relation to safe care and treatment.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff told us of an open and honest working environment, where they were supported by leadership, felt they were able to raise concerns and that their views were listened to and acted upon.

Representatives from the PPG felt the provider took concerns seriously and proactively made improvements to the service.

Staff understood how to raise concerns and report incidents. There was a system to record and investigate complaints. Learning from incidents resulted in changes that improved care for others. For example, protocols had been adjusted to clarify when it was appropriate to text patients.

The service worked with people and healthcare partners 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.

Referrals and test results were managed in a timely way. The completion of clinical tasks had improved, and an oversight system had been implemented and was monitored by the compliance administrator.

The practice ensured effective management and oversight of triage by having two duty doctors available each day to handle urgent patient issues throughout surgery opening hours.

There were systems in place for processing information relating to new patients. The service worked with other providers to deliver shared care and when patients moved between services. However, the access control policy needed to be amended to reflect the correct Caldicott Guardian. Leaders informed us that this was addressed promptly following our assessment.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 were able to tell us who the safeguarding lead was in the practice and how to raise concerns. They told us they received training in both safeguarding adults and children and had a clear understanding of their safeguarding responsibilities for reporting concerns. Additionally, the practice manager had completed level 4 training in safeguarding.

Safeguarding policies were in place and known to staff, however, due to recent changes in staffing the safeguarding policy needed updating to reflect the correct safeguarding lead. Leaders told us in response to this feedback immediate action was taken.

The practice had a chaperone policy in place, ensuring that chaperones were available to provide comfort and to help mitigate risk for both patients and staff.

The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations.

Disclosure and Barring Service (DBS) checks were undertaken when required.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

We saw examples of minuted multidisciplinary team (MDT) meetings involving health care professionals where patients were discussed to help manage risks associated with them.

Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and were aware of what action to take in a medical emergency . Staff received annual training in cardiopulmonary resuscitation (CPR ), basic life support, and management of anaphylaxis .

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Contracts were in place to ensure the premises were maintained. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed. There was a business continuity plan in place which was monitored and reviewed.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well 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 and staff were working within their agreed areas of competence. Safe recruitment practices were followed.

Learning and development were managed through one-on-one meetings, where individual needs were assessed, and training was tailored accordingly. During these meetings, staff members discussed their development goals, and plans were adapted to support their growth. For example, a Practice Pharmacist was being supported through an Advanced Clinical Practitioner apprenticeship, which had been planned during their initial reviews to ensure optimal timing for both the individual and the practice.

The service assessed and managed the risk of infection.

The practice had a designated infection prevention and control lead, and all staff had received relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions had been taken to mitigate risks.

We found there were no robust, regular processes in place to monitor certain long-term conditions and treatments. Our search of the practice’s clinical system found that:

There was a lack of oversight of patient’s currently prescribed a direct oral anticoagulant (DOAC), with 58.6% (307 out of 524) not having the correct monitoring in the past year and 10.6% (56) never monitored. Leaders responded immediately and implemented new processes.

The practice did not have an effective system in place for acting on legacy safety alerts. We identified 39 patients on both omeprazole and clopidogrel, which should not be prescribed together. Leaders told us immediate action was taken, and processes had been implemented.

Additionally, there was insufficient oversight of patients prescribed Warfarin, with 73 out of 74 patients lacking recorded monitoring. The provider had since obtained the necessary data and provided assurance that the monitoring is now documented on the clinical system.

However, systems were in place to monitor vaccines, emergency equipment and medicines. The emergency drug list lacked recorded quantities; this issue was addressed.

We saw staff had the appropriate authorisations to administer medicines under Patient Group Directions (PGD). Staff managed prescription stationery appropriately and securely. There was medical oxygen and a defibrillator on site and systems to ensure these were checked regularly and fit for use.

The practice could demonstrate the prescribing competence of non-medical prescribers, and regularly reviewed their prescribing practices.

The practice had taken steps to ensure appropriate antimicrobial use. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued by the provider for uncomplicated urinary tract infections was lower than local and national averages.