Grove Park 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 assessed all the quality statements from this key question. Our rating for this key question is good. We found the practice was providing a safe service overall. However, we identified some areas for improvement in relation to the learning culture and people’s experiences of receiving safe care.

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.

Some people told us they did not know how to complain and did not feel encouraged and supported by staff to raise concerns. We noted that the complaints procedure was located on the practice website and notices in waiting rooms signposted people to reception to access the procedure. After we made them aware, the provider made sure the complaints procedure was displayed in the waiting areas to promote open and honest communication between people and staff. Members of the current patient participation group (PPG) told us that practice leaders listened to their feedback. PPG members told us that they were involved in producing a feedback survey with managers and co-designing an action plan.

Staff told us that leaders and managers encouraged them to raise concerns when things went wrong. We saw evidence from staff meeting minutes that learning from complaints and safety incidents were regularly shared. There were clear arrangements to ensure learning was shared with staff who did not attend. All staff we spoke to told us the practice had an open culture, and that safety was a priority.

Leaders had clear processes for all staff to report safety incidents and accidents. Staff had undertaken training in significant events and learning events. There was a process to record and investigate complaints, and we saw evidence that staff apologised when things went wrong. We saw evidence that learning from safety incidents and complaints resulted in changes that improved care for people. However, we found a few examples of safety incidents and complaints that qualified as significant events but were not documented as such. We found that in some cases, significant event analyses lacked key details such as who attended the review and who was responsible for the follow up actions. The notes did not always consistently explain the reasoning behind the decisions made.

Several people told us because of difficulties filling out the online form, they were not confident that they would be dealt with promptly if their condition did not improve or they experienced any unexpected symptoms. Two people reported there had been a delayed diagnosis of their conditions because the first GP seen did not see the need to investigate further the symptoms described by the person. However, this view had changed on subsequent consultations with a different GP.

Staff told us about the processes in place to keep patients safe. They told us about pathways and transitions and demonstrated an awareness of the risks to people across their care journeys. For example, they explained how discharge summaries were promptly reviewed so the GPs knew which tests and treatments people had whilst in hospital to ensure safe and effective follow up.

There was evidence from multidisciplinary (MDT) team meetings of staff working with external healthcare professionals to effectively manage people with complex medical needs. MDT meetings were attended by a mix of professionals including the district nurse, the palliative care team and health visitors. Meeting minutes documented how individual cases had been managed. Visiting healthcare professionals in the service did not raise any issues in how the service interacted with them as professionals.

The provider had established and maintained systems to ensure safety was managed, monitored, and assured. For example, there were safe systems in place to monitor that people had attended their appointments following urgent referrals for suspected cancer.

People did not raise concerns about safeguarding.

Staff demonstrated they were knowledgeable about safeguarding processes. They could identify the practice’s safeguarding lead and had access to safeguarding policies and procedures. Staff understood their role when carrying out chaperoning duties and had undertaken training. Staff were knowledgeable about how to identify and safeguard people at risk of female genital mutilation (FGM). Staff told us about meetings they routinely attended to protect vulnerable people.

Visiting healthcare professionals in the service did not raise any issues about safeguarding.

Staff had undertaken safeguarding children and vulnerable adults training at the appropriate level for their role. Staff had undertaken chaperone training. There was a safeguarding register that was regularly reviewed and updated. We saw evidence from multidisciplinary (MDT) meeting minutes that safeguarding cases were reviewed and actions agreed on. MDT attendees included GPs, the palliative care team, the community matron, the district nurse and social workers.

People did not raise concerns about involving them in managing risks.

Staff and leaders understood the importance of including people in decisions about care and treatment. Where risks of treatment had been discussed with people, this was documented on the clinical system. Do not attempt cardiovascular resuscitation (DNACPR) decisions were made appropriately and documented on the medical record.

There were adequate systems to assess, monitor and manage risks to people’s safety. These had been shared with staff. Appropriately trained staff completed consultations and provided specific advice to people. Risks were recorded on medical records.

Staff were clear about their role and responsibilities in relation to health and safety. They knew who was responsible for specific areas of health and safety in case they needed to raise issues and knew how to access policies and procedures.

We did not observe any health and safety concerns during the assessment. All three surgeries had medical oxygen, a defibrillator and an appropriate stock of emergency medicines. All equipment and stock were in working order and in date. All three surgeries were adequately stocked with personal protective equipment.

The practice had undertaken health and safety monitoring to demonstrate a safe environment for all three surgeries. These included fire risk assessments, regular health and safety audits, water temperature checks for legionella bacteria, personal appliance testing (PAT) testing and equipment calibration, and infection prevention and control audits. Where risks had been identified, measures were put in place to negate them.

Some people showed concern that there was often no GP onsite at the branch surgeries throughout the whole week. Other people told us they felt supported by staff. They said staff were competent in their roles.

Staff and leaders told us there were enough staff to keep people safe. They told us how staff absences were managed. After we raised it with them, leaders changed the rotas to ensure a GP, or a nurse was always available at all three surgeries during core working hours. In addition, in response to a medical emergency at a branch site, the provider had updated the medical emergency policy and ensured staff knew how to access emergency equipment. Staff training in basic life support, anaphylaxis and sepsis had also been refreshed following the incident.

Managers provided evidence to demonstrate that staff had the skills, knowledge and experience to carry out their roles safely. Both clinical and non-clinical staff had undertaken training specific to their role and there was effective oversight of this. All staff had up to date safeguarding, infection prevention and control, and basic life support training. We saw evidence of effective recruitment procedures and an induction process for new staff members. The practice demonstrated a good skills mix of clinical staff providing specialist care in areas such as diabetes, asthma and women’s health.

People did not raise any concerns about infection prevention and control.

Staff were aware of their Infection Prevention and Control (IPC) responsibilities for example, how to respond to an outbreak. Staff were able to name the IPC lead. Staff told us they could raise IPC concerns in team meetings. Staff knew how to manage clinical waste and specimens.

Appropriate standards of cleanliness and hygiene were met. All three surgeries were visually clean during the assessment. There were arrangements in place for managing waste and clinical specimens. Sharps bins were safely managed. Staff had access to adequate supplies of personal protective equipment.

Staff had undertaken IPC training. Policies and procedures were accessible to staff. IPC audits had been carried out for all three surgeries and action plans implemented. A process was in place to record, and risk assess staff vaccinations in line with national guidance.

Several people told us that annual health checks for their conditions were overdue, and some people had not had their medication reviews completed. However, most people did not raise any concerns about their medicines and prescriptions.

Staff received regular training on medicines management, and felt confident managing the storage, administration and recording of medicines. 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.

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

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes. Published data showed that between April and June 2024 the prescribing of three-day courses of antibiotics for uncomplicated urinary tract infections was in line with national targets. Data showed that the prescribing of medicines for the management of disabling long-term conditions, including epilepsy neuropathic pain and generalised anxiety disorder was better than national targets. Data showed that the prescribing of medicines to treat mental health disorders that require close monitoring were in line with national targets.