Downton 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

The practice promoted a culture of openness and collaboration. Staff were encouraged and supported to raise concerns. The management listened their concerns, recorded and investigated them and made changes to practice if required. There were systems and processes in place to monitor patients and inform safe prescribing practice. However, these required strengthening to ensure consistency in the monitoring of patients and ensure safe prescribing practice.

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.

The practice encouraged and supported people to raise concerns and share compliments. They listened to and responded to their experiences of the service. The practice reviewed and responded to complaints in a timely and professional manner. Learning was identified from significant events and the practices made changed in response to feedback such as fast tracking patients presenting with poor mental health and how they managed patient information.

We found the staff were receptive to feedback from patients, staff and the regulator. Leaders told us they wanted to provide safe care and appreciated and supported staff to raise concerns. They understood feedback provided an opportunity for lessons to be learnt and improvements to be made to the service. We saw how issues raised by staff had been investigated and changes made to improve the service to patients. For example, processes for dispensing medication had been improved. We also reviewed GP weekly meeting minutes where changes to practice such as the introduction of new guidance were discussed.

There were processes in place to ensure the timely, accurate and appropriate reporting of concerns. This including analysis of expected and unexpected deaths including patients placed on their palliative care register and those receiving new serious diagnoses. All were investigated and reviewed providing staff with an opportunity to reflect on the experience of patients. Any learning identified was shared amongst the clinical and wider practice team where appropriate. However, records reviewed of concerns did not always show, when and where learning had been shared with staff or if audits had been revisited and changes embedded to improve practice.

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.

People reported that staff were good at listening to them. They were treated with care and concern and involved in decision about their care and treatment. People were provided with information on their medicines and how to access to support. The recent introduction of a new dispensing system had reduced waiting times for patients to receive their medicines. Staff told us they were able to fulfil prescription requests the same day and people had been positive regarding the service.

Staff were trained and their prescribing behaviours monitored and overseen by the medicine management lead. Best practice was shared during clinical meetings with staff and regular audits were conducted to check standards of care.

Staff utilised clinical templates to conduct consistent assessments and assist them in identifying and responding to individual's needs. Staff prescribed, administered and monitored people on medicines. However, we found some inconsistencies in staff adhering to best practice guidance.

There were systems in place to support staff to prescribe medicines safely. Prescribing templates were utilised by staff to assess, review and support prescribing. The practice had an appointed medicines management lead who conducted audits on their prescribing behaviours. The medicine management lead conducted regular system wide checks on prescribing. Where anomalies were identified with individual clinical practice these were raised with the prescribers, investigated and actions taken to safeguard the patient such as scheduling a review of their care, arranging monitoring (blood tests, blood pressure checks, recording height and weight). There were establish shared care agreements. However, improvements were required to strengthen these systems as we found national guidance was not consistently followed. Previous audits checking on the management of medicines to ensure their integrity (cold chain) had not been followed up to ensure improvements to practice had been made and were consistently employed.

People’s health conditions were actively monitored by clinicians. Where audits have highlighted improvements in clinical performance are necessary, they have focussed on delivering care to these patient groups including commissioning clinical services to support their staff. For example, conducting asthma reviews. The practice was improving the advance care planning for people receiving end of life care. Staff have training scheduled with the palliative care team to increase their understanding and confidence in applying the principles of the Gold Standard Framework. Thereby, ensuring peoples wishes were heard, considered and respected when delivering care and treatment.