Iridium Medical Practice

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We carried out an assessment of 5 quality statements under the Caring key question.

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment, we rated this key question as good. At this assessment, the rating has changed to requires improvement.

People were not always treated with kindness and compassion. The provider could not demonstrate that staff always treated patients as individuals and supported their preferences or that patients had choice in their care and treatment. The provider did not always support staff wellbeing.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients’ privacy was promoted. Younger adults had control over the amount of parental involvement in managing their care and support. However, the service did not always treat people with kindness, empathy and compassion. Patients reported through feedback to CQC they did not always feel treated with kindness, empathy or compassion. Staff did not always treat each other or colleagues from other organisations with kindness and respect. For example, some staff reported being shouted at by other members of practice staff. Data from the 2024 National GP Patient Survey reflected patients did not always feet listened to or feel they were treated with care and concern. For example, of those patients responding to the survey, 78% felt at their last appointment the healthcare professional was good at listening to them, this was lower than the national average of 87%; 85% of patients had confidence and trust in the healthcare professional, this was lower than the national average of 92%. The practice’s in-house patient survey in December 2024 showed that results were more positive. Where satisfaction was still lower than expected the provider had produced an action plan, for example, they planned to add alerts to vulnerable patient’s records to try to improve continuity in care for them. Patient feedback CQC had received indicated that patients did not feel supported to raise concerns, patients felt intimidated by staff and some staff were described as being aggressive. There had been 13 reviews left on the NHS website between July 2024 and January 2025. Of these reviews, 9 were positive about staff, that staff were caring and patients felt they had been treated with kindness. During our inspection, we observed members of reception and clinical staff being caring towards patients and supporting them as needed. We received mixed feedback from care home staff. They commented positively about the GP and that they felt treated with respect. However, they did not feel they were always treated with kindness and respect by other staff at the practice.

Patient’s communication needs were met to enable them to be fully involved in their care. Staff told us that interpreting services were available when needed. Information was available in different languages and formats.

However, the service did not always treat patients as individuals or make sure their care, support and treatment met their needs and preferences.

During our record reviews we saw some evidence of patient’s records having digital flags to alert staff when patients required additional support to access services, for example if an interpreter was required. However, there was limited evidence of other reasonable adjustments being recorded.

We also found that when patients had carers this was not always digitally flagged onto their record to alert staff.

From information the provider sent us we saw that they had identified this was an area for improvement and had plans to review the digital flags placed on patients records in particular for those patients with learning disabilities or mental health problems.

Staff referred patients to the social prescriber for additional support and carers had access to community-based services that would help promote independence.

From data we viewed, we saw that use of the NHS APP to book an appointment or order repeat prescriptions had increased. This improved patient’s independence and control over these processes.

Patient feedback was mixed and included that patients could use an online link to book their appointment which gave them a choice of times and dates, however other patients told us they could only make a GP appointment for that day and not for the future.

Patients also told us they were not always informed when appointments were cancelled and when appointments were running late, they were not told about waiting times.

Other patient feedback CQC received included that patients were not always made aware of risks or provided with additional information to help inform decisions.

Patients also told us that delays with repeat prescriptions impacted negatively on their health and wellbeing and did not promote independence.

From care plans we reviewed, the provider could not demonstrate that patients were always involved in decisions about their care and treatment.

Results from the 2024 National patient GP survey showed that of those patients completing the survey, 13% usually got to see or speak to their preferred healthcare professional when they would like to. This was lower when compared to local (32%) and National results (40%).

The practice had carried out an in-house patient survey in December 2024 to monitor patient experience, 331 patients had responded. Results were more positive. The provider recognised that further improvements were still required and had included this on their action plan.

There was a system for appointment triage supported by a daily on-call/duty GP that ensured patients with urgent needs had access to services. Staff we spoke with knew the process for referral to emergency support.

However, the service did not always listen to and understand patient’s needs, views and wishes. Staff did not always respond to patient’s needs in the moment or act to minimise any discomfort, concern or distress.

Feedback from care home staff included that although the practice responded promptly to queries and they were able to get telephone support from a GP there were often delays in providing home visits to care home residents.

Patient feedback CQC received included negative feedback about getting the right support or advice to meet immediate needs.

Results from the National patient GP survey showed that 66% of people completing the survey found the reception and administrative team helpful. This was lower than the local result (76%) and National result (83%).

Data from the practice’s in house patient survey (December 2024) showed that of those patients completing the survey, 78% found reception and administrative staff helpful. We saw the provider had acknowledged this was still an area for improvement and had included this on their action plan. Actions included making improvements to their website and arranging training for receptionists to improve their customer care skills. The provider planned to continue to collect patient feedback in order to make further improvements.

The provider had processes to assess and manage risk related to staff wellbeing. Staff gave us examples of when these risk assessments had been completed and changes made to support them at work.

However, the provider did not always promote the wellbeing of their staff or always enable staff to deliver person-centred care.

For example, we found the provider did not have effective processes to ensure staff immunisation risk assessments were carried out and monitored or that staff received an effective induction.

Staff feedback was mixed. Some staff told us they were valued and respected by leaders. Other staff felt less valued, did not feel like they were treated equally or did not always feel they were treated with respect or kindness.

Some staff felt they could not raise concerns with leadership for fear of repercussions or if they did, their concerns would not be taken seriously.

All staff we spoke with told us they were supported clinically and could get clinical advice if needed. However, we saw that formal clinical supervision for non-medical prescribers was on hold at the time of the assessment.

Some staff felt they had excessive workloads. Other staff expressed concerns over being asked to carry out tasks that did not align with policy or process but did not feel able to raise or question this with leaders.

We saw evidence of insufficient staffing and inappropriate workflow processes that meant non-clinical staff were working on weekends and bank holidays to clear the backlog of letters that had been received. This in turn placed additional pressure on clinicians to continue to process those letters within agreed timescales.

The provider told us they had recruited clinical and non-clinical staff..

The provider had carried out a staff wellbeing survey in 2023. We did not see evidence of an action plan or a repeat survey that demonstrated that any actions implemented after the initial survey had been successful.