Dr Sinnadurai Thillainathan

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 quality statements from this key question. We have combined the scores for all areas. Our rating for this question is good. We found safety was a top priority, and staff took all concerns seriously. When things went wrong, staff acted to ensure people remained safe. Managers investigate all reported incidents to reduce the likelihood of them happening again. Processes were in place to ensure the safe management of medicines. Staff supported people to live healthier lives and provided them with support and information on their care and treatment.

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.

Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from significant events, incidents of safeguarding and clinical issues. Staff felt there was an open culture, and that safety was a top priority.

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 felt safe when attending the service. People were always directed to the most appropriate clinician to help with their care needs. This included referrals to external services.

The staff we spoke with were aware of care pathways, including referrals and taking on the care of those patients who had been discharged from other services. Leaders at the service shared relevant information with staff in team meetings.

The service had sought feedback from relevant partner organisations in relation to the use of safe systems and pathways. They reported that they were satisfied that these processes were clear and were being followed.

The service had processes in place to ensure that referrals were managed quickly. There were also systems in place to ensure that where care was shared, information was shared between organisations. For example, when a patient had been referred to secondary care and follow up was required by the service.

Staff at the service to whom we spoke were aware of how to make safeguarding referrals, and knew the identity of the organisational lead if further advice was needed. Leaders told us how advice was available externally via the Primary Care Network (PCN) if required.

The provider was involved with the Primary Care Network (PCN) and other local bodies for the management of safeguarding referrals. Partners stated that there was a good working relationship that enabled safeguarding processes to run smoothly.

The provider worked with other agencies to support patients and protect them from neglect and abuse. Staff took steps to protect patients from abuse, neglect, harassment, discrimination and breaches of their dignity and respect. The provider carried out staff checks at the time of recruitment and on an ongoing basis where appropriate. Disclosure and Barring Service (DBS) checks were undertaken where required. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable). All staff received up-to-date safeguarding and safety training appropriate to their role. They knew how to identify and report concerns.

People felt risk was managed well. When an issue occurred that could put them potentially at risk, they felt the practice managed this appropriately.

Leaders told us that staff were informed on how to manage risk, and that standing items such as safeguarding and incidents were discussed at meetings. Staff reported that they were comfortable in reporting when things went wrong.

There were processes in place for risks to be reported, reviewed and discussed with all staff. The provider had processes in place to ensure that patients who had the most urgent needs were prioritised.

Leader told us that processes and procedures were in place to ensure a safe environment. The processes included all of the rooms within the building that they were responsible for. The landlord was responsible for the cleaning of the whole building, and systems were in place to ensure prompt communication when there were concerns.

The provider had four rooms in the health centre building, one of which was a reception and office. They also shared rooms with other services in the building through a booking system. On the day of inspection we observed that the area to the side of the practice reception contained filing cabinets and a number of cardboard boxes. We were informed these were the property of another service based in the building and that the landlord was aware and arrangements were in place for these to be moved in the near future. Since the inspection visit we have been provided with reassurance that this area is now clear from obstruction. The rest of the corridors and public areas were clean and uncluttered. Clinical rooms were of an appropriate standard. The reception office held a large amount of technology equipment and paperwork. The provider had risk assessed and had taken actions to mitigate identified risks. The practice advised us they were in talks with the landlord to acquire more space in the building but this was taking time. Cleaning was undertaken by a company supplied by the landlord.

The premises from which services were based had been risk assessed, and the provider had undertaken a full range of other risk assessments, including premises security and infection, prevention and control (IPC) to assure themselves that the service that it was providing was safe for patients and staff.

People were happy with the clinical staff that they had appointments with. Their needs were always met appropriately. There was confidence in the staff employed by the provider.

Leaders detailed how staffing had been based around the needs of the patients that they serve. This included the use of pharmacists from the Primary Care Network (PCN) to take some strain off the GP service. Partner GPs used long term locums to compliment the clinical team with GPs covering each others absence. The provider did not use a locum agency.

The provider had a range of workforce planning measures in place to ensure that the correct level of staffing was in place. There was a clear induction programme. Staff received appropriate ongoing training and yearly appraisals. All staff were appropriately trained.

Staff stated that infection prevention and control (IPC) was a priority. Regular cleaning took place by an external company and clinical areas were cleaned between patients. The provider was in contact with the cleaning company and was able to raise concerns promptly.

We observed the practice, although cluttered in places, to be clean. There were a number of minor points on the infection prevention and control (IPC) audit that the practice was working through. Many of the points on the audit were the responsibility of the landlord who was in the process of actioning those points.

The provider had appropriate processes in place for the implementation of infection prevention and control (IPC) systems. This included a comprehensive policy and up-to-date risk assessments. All staff had received IPC training appropriate to their role.

Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms.

Staff received regular training on medicines management. Staff managed medicines related stationery appropriately and securely. Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring. The primary care network (PCN) pharmacists based at the practice took a lead role in the management of medicines, including managing repeat prescribing systems, reviews and clinical audit.

Staff managed medicines safely and regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines and controlled drugs. Staff told of how they disposed of expired or unwanted medicines that patients had returned. Staff stored medical gases, such as oxygen, safely and completed the required safety risk assessments.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. Appropriate monitoring was in place and regular audits were undertaken.

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 audit of prescribing that focused on improving care and treatment.