Cranford Medical Centre

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 has improved from requires improvement to good. We found safety was a top priority, and staff took all concerns seriously. When things went wrong, staff acted to ensure people remained safe. Managers investigated all reported incidents to reduce the likelihood of them happening again. Staff supported people to live healthy lives and provided them with support and information on their care and treatment.

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.

People felt supported to raise concerns and told us staff treated them with compassion and understanding. Representatives from the patient participation group felt the provider took concerns seriously and proactively made improvements to the service.

Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from complaints, concerns and incidents. Staff felt there was an open culture, and that safety was a top priority.

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.

People we spoke to had no concerns about their transition between services.

Staff told us they worked with patients and partners to keep people safe, this included continuity of care when people moved between different services. Staff had clear responsibilities including handling referrals to other healthcare providers and updating patient records with hospital discharge information to ensure continuity between secondary and primary care.

There was evidence from multi-disciplinary team meetings that the practice worked with other healthcare professionals to effectively manage patients with complex medical needs. We did not receive any concerns from partners about the care people received.

The provider had established and maintained systems to ensure safety was managed, monitored, and assured. There was a safety netting process in place to ensure people attended their appointments following urgent referrals.

People we spoke to had no concerns about safeguarding.

Staff 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. Staff understood their obligations for reporting people at risk of female genital mutilation (FGM).

There were no concerns from partners relating to safeguarding.

Staff had undertaken safeguarding children and vulnerable adults training at the appropriate level for their role. Chaperone training had been undertaken by staff. There was a safeguarding register that was regularly reviewed and updated.

Results from the GP patient survey showed that the practice was performing in line with England averages in relation to involving people in decisions about care and treatment.

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 patient records.

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 patient records.

Staff were clear about their role and responsibilities in relation to environmental safety and who was responsible for oversight of specific areas, such as health and safety, infection prevention and control, and fire safety.

We noted that there were adequate safety notices throughout the practice apart from the room where medical oxygen was stored, which required oxygen signage on the door. Following our assessment, the practice sent evidence that this had been rectified.

The practice had undertaken all the necessary risk assessments to demonstrate a safe environment. These included risk assessments for fire, legionella and asbestos. Risk assessments were up to date with completed actions. Portable appliance testing, calibration of medical equipment and fire equipment checks were documented. Lead roles for health and safety were clearly defined.

People we spoke to told us they were generally happy with staffing arrangements. They told us that staff were friendly and helpful. Some people told us that seeing the same GP was often an issue which affected continuity of care.

Staff and leaders told us there were enough staff to keep people safe. They told us how staff absences and clinical cover were effectively managed.

We were assured that staff had the skills, knowledge and experience to carry out their roles safely. Staff had undertaken the necessary role specific training and mandatory training such as safeguarding, infection control and basic life support. A tracker was in place to ensure training was updated when necessary. There was effective recruitment and induction processes for new starters. Policies for these areas were accurate and up-to-date.

People we spoke to had no concerns relating to infection prevention and control (IPC).

Staff were aware of their 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. The premises were visually clean on the assessment day. There were arrangements in place for managing waste and clinical specimens. Sharps bins were appropriately managed. Staff had access to personal protective equipment.

Staff had undertaken IPC training. Policies and procedures were accessible to staff. An up-to-date IPC audit had been carried out and an action plan completed. We identified on the assessment day that tiled areas behind sinks had not been identified as a potential cross-infection risk. Following the assessment, the practice sent us an updated IPC audit which included steps to replace the tiling. A process was in place to record, and risk assess staff vaccinations in line with national guidance.

Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People 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 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, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of medicines to treat epilepsy and anxiety issued by the provider was lower than local and national averages. There was a programme of regular clinical auditing of prescribing that focused on improving care and treatment.