Knightwick Surgery Also known as Drs Bywater, Salter & Hinton

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 protectable harm. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

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.

The practice had processes in place for staff to report incidents, near misses and safety events. They listened to concerns about safety and appropriately investigated and reported safety events. During staff meetings, significant events and learning was discussed to improve care for others. Patients felt supported to raise concerns and felt staff treated them with compassion and understanding.

The practice had systems in place to support patients moving between different services to enable continuity of care. The practice worked with other providers to deliver shared care and patients told us they appreciated how they received test results in a timely manner. There was a process in place to check all patients with 2 week wait referrals had been referred appropriately and received their appointment with a specialist. Feedback we received from patients reflected this.

The practice worked with patients and healthcare partners to understand what being safe meant to them and the best way to achieve that. The practice had effective systems and processes in place to ensure patients were protected from abuse and harm. Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures.

The practice worked well with patients to understand and manage risks. They provided care to meet people’s needs that was safe and supportive. Patients were advised on risks related to their condition and actions to take if their condition deteriorated. Patients told us they felt fully involved in their care and treatment. The practice had appropriate systems in place to ensure a deteriorating or acutely unwell person was identified and managed safely. They held regular emergency drill scenarios and learning was shared afterwards to improve care for others.

The practice had effective arrangements to monitor the safety and upkeep of the premises. They made sure equipment, facilities and technology supported the delivery of safe care. We observed the practice including facilities and equipment to be well-maintained, accessible and suitable for the intended purpose. The practice had maintenance records for checks of the fire alarm system, fire extinguishers and emergency lighting. Health and safety risk assessments had been completed and risks identified had been addressed. Portable appliance testing was completed annually to ensure equipment was safe to use.

The practice made sure there were enough qualified, skilled and experienced staff, who received regular effective support, supervision and development. We saw evidence of staff being upskilled to support their development and the practice. We found some gaps in training, but the practice acted promptly to rectify this. When we spoke to staff, we were confident they had good knowledge of the gaps identified.

The practice had processes in place to assess and manage the risk of infection. The practice had an infection prevention and control (IPC) policy in place, but it did not contain contact details of the IPC lead. However, the practice did have an IPC lead and staff were aware of who this was. We saw evidence of regular audits being completed and actions taken to mitigate risks. All staff had completed appropriate training and were aware of what action to take in the event of a sharps contamination injury.

The practice made sure that medicines and treatment were safe and met patients’ needs, capacities and preferences. They involved patients in planning, including when changes happened. The practice had systems to manage and respond to safety alerts and medicine recalls. The practice completed regular clinical audits to identify and follow up patients who were affected. Regular medicines reviews were carried out to ensure patient medicines were appropriate to their needs. However, we found some of these reviews were just a code. The practice had flagged alerts on their system to highlight when a patient required monitoring such as their blood pressure. We found some alerts had not been removed or recoded, despite monitoring being up to date. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines and controlled drugs. There were suitable processes for staff to follow when dispensing medicines. Patients told us they received their medicines in a timely manner and the dispensary team were helpful when dealing with their enquiries. The number of antimicrobials issued by the provider was higher than the national average. However, the practice had recognised this and had taken steps to improve this.