Pearl Medical Practice

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• 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 4 quality statements from this key question. We have combined the scores for these statements with scores based on the rating from the last inspection. We looked for evidence that people were protected from abuse and avoidable 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.

We received feedback from representatives of the patient participation group who spoke positively about how the practice made improvements to the service in response to patient feedback.

Managers encouraged staff to raise concerns when things went wrong and led by example. Staff understood their responsibility to report incidents and to be open with people when things went wrong. The team discussed and learnt from clinical issues.

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. The practice had recently become aware of an issue affecting test results and had involved stakeholders and people using the service to ensure the problem and all associated risks were fully resolved.

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.

People participating in the assessment did not directly comment on safeguarding but several did report that the practice team supported more vulnerable family members very well.

Leaders were able to demonstrate how safeguarding was managed in the practice. There were discussions with other health and social care professionals when needed, to support and protect adults and children at risk of significant harm. Staff were trained to the appropriate levels for their role.

Representatives from partner agencies did not raise any concerns about safeguarding at the practice.

The practice had clear systems, practices and processes to keep people safe and safeguarded from abuse. Safeguarding was a standard agenda at practice meetings.

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.

Staff told us the environment, facilities and equipment were well-maintained so they could work safely and deliver a good quality of care to their patients. Staff were aware of the procedures for emergency evacuation, for example, in the event of fire.

We found no concerns regarding the care environment, equipment or facilities during our site visit. The equipment we inspected had been appropriately checked and serviced to ensure it was safe to use. The practice was equipped and ready to deal with medical emergencies.

Emergency equipment, including emergency oxygen and an automated external defibrillator (AED) were regularly checked by staff to ensure they were safely stored and fit for use. The practice had risk assessed which emergency medicines to stock and monitored stock levels and expiry dates to ensure these medicines were safe to use.

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.

Patients did not raise any specific concerns about their experience of medicines optimisation at the practice.

Leaders, clinicians and staff were confident about the way medicines were prescribed. Clinicians and staff told us that they were trained and there were clear policies and protocols that they followed to ensure medicines were prescribed safely. Clinicians and staff told us that there was good communication about medicines and prescribing, for example, any required changes to people’s medicines after discharge from hospital were actioned promptly within the practice.

Vaccines were appropriately stored, monitored and transported in line with guidance to ensure they remained safe and effective. There were systems in place to ensure medicines related stationery was stored, distributed and disposed of safely and securely.

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 were monitored in line with guidelines. The practice had a programme of audit to review its prescribing activity and performance.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes. Prescribing data reviewed as part of our assessment confirmed this. For example, the rates of hypnotic prescribing; antibiotic prescribing and the percentage of patients prescribed multiple psychotropic medicines by this provider were significantly lower than the national averages. (A psychotropic medicine affects the chemistry of the brain and mood).