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Audit tool: Delivering a safe and effective service

Details for quality assurance in delivering a safe and effective service can be found below. Please download the audit tool from the bottom of the page.

Part 1A: Data collection from patient records

There is evidence in the patient records that consideration is given, where appropriate, to

  • safeguarding children 
  • safeguarding vulnerable adults 
  • national child protection guidance 
  • control and prevention of infection 
  • lone working 
  • chaperoning 
  • interpreters 

Risk management to include

  • Consideration of the management of risks
  • indications for a risk assessment carried out for every service user, prior to each procedure or treatment 
  • the analysis of findings from risk assessments to make recommendations for changed work practices
  • action taken on the results of the risk assessment, to minimise any hazards identified 
  • weighing and recording of the weight of service users where indicated 
  • safe equipment for the care of bariatric service users 

Considerations of the risks of members working alone to include

  • communication links between members working alone and their base
  • the use of personal alarms

Part 1B: Data collection from organisational policies and procedures

The organisation has in place

  • A planned orientation and induction programme for all CSP members working in new roles 
  • Recording where members attend the orientation and induction programme 
  • Procedures for members to provide feedback on the programme to ensure its continued relevance 
  • An organisational policy to ensure that mandatory training is completed within agreed timescales 
  • Notices of hazards to service users prominently displayed in areas of known risk 

There is a policy for the induction programme which includes

  • A named person responsible for planning and for implementation 
  • A named person responsible for evaluation and review to ensure it continues to fulfil its intended purpose 
  • The content and structure of the programme 
  • Locally agreed time-scales for completion of the programme 
  • Issue of the programme to each new physiotherapy team member 

There is an organisational policy to ensure that CSP members receive training in

  • fire procedures 
  • life support 
  • moving and handling 
  • dealing with violence and aggression 
  • control and prevention of infection 
  • confidentiality 
  • information governance 
  • safeguarding children and vulnerable adults 
  • familiarisation with record keeping systems (paper storage or electronic access) 
  • approach to record keeping within team (style/use of acronyms and short forms etc)

There are systems in place to identify, report and learn from patient safety incidents and other notifiable incidents, using appropriate local and/or national governance systems and to demonstrate resulting improvements in practice.

There is a health and safety policy which includes procedures to manage

  • fire 
  • waste disposal 
  • disposal of medical waste 
  • resuscitation 
  • first aid 
  • control and prevention of infection 
  • disposal of sharps 
  • lone working 
  • chaperoning arrangements 
  • interpreters 
  • working outside normal hours 
  • control of substances hazardous to health
  • safe moving and handling of loads report of industrial diseases and dangerous occurrences
  • planned maintenance
  • rehabilitation eg practising stairs policy 
  • to summon urgent assistance when required

There are policies in place for the maintenance of

  • temperature
  • humidity
  • lighting
  • ventilation

There is an organisational policy for risk management which includes

  • Evidence of a regular health and safety audit in accordance with locally defined timescales
  • Clearly defined procedures for the management of risks
  • Training for members to undertake risk assessments which includes identification and effective management of risks 

Indications for a risk assessment

  • carried out for every patient, prior to each procedure or treatment
  • risk assessment carried out for every activity involving a physiotherapy team members 

The analysis of findings from risk assessments to make recommendations for changed work practices Procedures for taking action on the results of the risk assessment, to minimise any hazards identified.

There are organisational policies in place, which are followed, which include

  • visual and physical safety checks of medical devices prior to use or issuing to service users 
  • the use of medical devices according to manufacturer’s instructions 
  • cleaning of medical devices according to manufacturer’s instructions and policies for control and prevention of infection 
  • regular servicing of medical devices and action taken 
  • a reporting system for identification, reporting and recording of action taken regarding faults of medical devices 
  • removal of faulty medical devices 
  • registration to receive by email patient safety and MRHA alerts 
  • a process for cascading information on ‘Patient Safety Alert’ notices 
  • a procedure for acting upon Patient Safety Alerts and other communications that relate to the safe provision of physiotherapy
  • ensuring that action is taken on new guidance about medical devices safety and on ‘Patient Safety Alert’ notices issued on treatments/ interventions that affect practice 
  • evaluation of new medical devices in the context of a clinical trial to ensure it meets the requirements of research governance 
  • recording of all medical devices loaned to service users 
  • recording of medical devices purchased by the service user and the instructions on its use 
  • instructions for safe use of any medical devices issued 
  • physiotherapy team members are trained appropriately and a training record is kept in issuing and maintaining medical devices 
  • Equipment for the care of bariatric patients includes visible maximum weight of furniture (treatment couches, waiting room chairs, department toilets and upstairs flooring)
  • provision to weigh patients 

There are organisational policies in place for lone working which are followed, which include

  • Physiotherapy team members working alone, and treating patients alone 
  • establishment of communication links between the physiotherapist working alone and their base 
  • use of a personal alarm carried by physiotherapists when the risk assessment requires it 
  • where known risks exist, that patients’ homes are not visited alone 
  • opportunity for service users and staff to have a chaperone

Part 2: Service user feedback

During my treatment

  • There were notices of any hazards or risks 
  • I was informed of any risks relating to the treatment 
  • I was given instructions and safety warnings on any medical devices 
  • I was aware of how to call for help if needed

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