The Medical Centre Crabbs Cross

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

Leaders and staff provided patients with safe care. Staff ensured medicines and treatments were administered safely. Staff made sure clinic areas were clean and well maintained. Staff wore personal protective equipment where required. Staff were recruited safely. They received an induction and appropriate training in areas such as safeguarding adults and children. Staff received training in areas such as safeguarding and knew how to use these processes to keep patients save from harm.

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.

Patients felt supported to raise concerns and staff treated them with compassion and understanding. Patients received support to understand the treatments they were offered.

Staff received regular updates based on targets and data. This was delivered through regular team meetings. These were not used for learning although staff were offered the opportunity to contribute to the items being discussed.

The provider had a significant events policy in place and 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 was not always shared with staff so they could use this to improve their practice.

Patients received safe and continuous care. They were able to see the same GP and referrals were made promptly. This happened through joined-up working between the provider and other services when people were moving between services.

Staff used a documented system for referrals and for monitoring these if there were delays. Staff told us they knew how to communicate results to patients, and this was done in a timely way.

Partners from external teams who worked with staff were positive about their interactions. Partners said they worked well with the practice to ensure patients received care and treatment in a timely way.

Leaders had a referral policy and appropriate processes in place for referral to other services. This included urgent referrals to specialist services such as the hospital. Staff had a protocol in place to check referrals which should be seen within 2 weeks were followed up and action taken if needed.

Staff and leaders told us they were aware of the safeguarding systems, processes and practices. They received training in safeguarding and how to recognise domestic abuse. Staff knew who to speak with if they had a query or concern and which services would be available to support patients.

Partners participated in multiagency meetings with the practice. Safeguarding patients particularly those who were vulnerable due to age or health conditions was discussed during these meetings to ensure people were safe.

Leaders had policies in place for safeguarding adults and children. They ensured staff received appropriate training. A GP was the safeguarding lead supported by a second staff member to cover in their absence. Referrals were made as per the policy and followed up when needed.

Patients were fully involved in their care and treatment. Staff discussed potential risks with them and ensured they had the information needed to keep themselves safe.

Leaders and staff involved patients in managing risks to their health. Treatment options were discussed, and advice given with follow up appointments where appropriate.

The provider had systems and processes in place to ensure staff understood the need to fully involve patients in managing risk. Staff followed internal policies and operating procedures which were based on best practice guidance when assessing and treating patients. Assessments were detailed and covered all aspects of risk to ensure patients received the appropriate treatment and support.

Patients were positive about the cleanliness of the practice. They felt that the improvements to the environment such as the automatic doors had made it easier when visiting the building.

Leaders took responsibility for the building and ensured it was fit for purpose. They had a range of clinical areas on the ground floor, a small waiting area which was fully visible to reception staff and space for meetings. Staff felt this was a safe environment to work in. Staff were clear about what to do in an emergency. They knew how to raise the alarm if needed. Reception staff had alarm buttons linked to the computer system. As the practice building was small, staff could easily call for help if the computer system was not working and other staff would come to help. Staff were clear on their roles and responsibilities in an emergency.

Facilities and equipment in the premises were well-maintained and were suitable for the intended purpose. On the day of our visit the premises were visibly clean and tidy. Leaders had started making improvements to the environment such as automatic doors to make access easier for patients.

Leaders had effective arrangements to monitor the safety and upkeep of the premises. The service conducted safety risk assessments such as fire, Control of Substances Hazardous to Health (COSHH) and Legionella (a term for a particular bacterium which can contaminate water systems in buildings). The service undertook annual portable appliance testing to ensure equipment was safe to use.

Patients were able to see the staff they wanted to when they booked an appointment. They had the choice of seeing a male or female GP and this was a positive change made by the practice. Reception staff were welcoming, well informed and supportive.

Staff received support when requested from leaders. Staff received training which was appropriate and relevant to their role. Staff attended regular meetings and clinical staff received supervision. Administrative staff had an annual appraisal but no formal supervision and would benefit from having regular one to one time with leaders to discuss their work. Staffing levels were sufficient to provide care and treatment.

We observed there were enough staff to meet the needs of patients during the site visit. Staff were friendly and welcoming to patients. Staff answered calls promptly and tried to accommodate patients requests for appointments.

Staff were recruited safely and in accordance with regulations. All necessary pre-employment checks were being completed. This included asking for references and completing checks with the Disclosure and Barring Service. These checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Patients had no concerns about infection, prevention and control (IPC) when they visited the practice. Staff used gloves, aprons and masks and washed their hands during appointments.

Staff had completed appropriate IPC training relevant to their role. Staff told us they knew their roles and responsibilities around IPC.

We observed the premises to be visibly clean. All staff we observed adhered to current IPC guidance. Staff had access to appropriate personal protective equipment (PPE) and hand washing facilities in clinical rooms. Staff maintained a hygienic environment by cleaning equipment between use, disinfecting surfaces, and routinely cleaning clinical areas.

Leaders managed IPC well. They had policies and procedures were in place to support staff. Regular IPC audits were completed to identify where improvement could be made.

Staff involved patients in reviews of their medicines and helped them understand how to manage their medicines safely. Patients 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, 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 took steps to ensure they prescribed medicines appropriately to optimise care outcomes. Prescribing data reviewed as part of our assessment confirmed this. Patients with long term conditions received regular follow ups. There was a programme of regular clinical auditing of prescribing which focused on improving care and treatment.

Vaccines and medicines were stored safely however emergency medicines were not being counted and recorded accurately. For example, one medicine packet contained 15 tablets, but records stated there were 10 tablets. Other items recorded 5 items in the packet when there were only 4 tablets. This was discussed with leaders during the assessment who agreed to review the system for recording these items. Fridge temperatures were being checked twice daily in line with national guidance however there were four dates in July 2024 when the temperature was only recorded once daily. Staff said this was an oversight and the thermometer had an alarm on it which would have alerted them if the temperature had been outside of the normal range.

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. There were suitable processes for staff to follow when dispensing medicines. During our clinical searches, we observed processes in place for monitoring patients’ health. This was in relation to the use of medicines including medicines which require monitoring with appropriate clinical review prior to prescribing. We found no concerns with our clinical searches.