Priory 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 quality statements in the safe key question. This inspection was carried out following changes to the practice’s registration with the Care Quality Commission (CQC) which included a relocation to purpose built premises in August 2022. This key question has been rated as Good. The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. Staff understood and managed risks. People were protected and kept safe. The facilities and equipment met the needs of people, were clean and well-maintained. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training to maintain high-quality care. Medicines were managed well.

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.

The service had a proactive and positive culture of safety, based on openness. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The practice engaged with Patient Participation Group (PPG), took patient concerns seriously and proactively made improvements to the service. The PPG had 7 members who also attended external patient engagement groups and fed back suggestions for improvement.

Complaints records showed that complaints received in the last 12 months had been acknowledged and acted on. There was a clear complaints process with learning from themes and trends.

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

The service worked with other providers to deliver shared care and when patients moved between services. Referrals and test results were managed in a timely way which was supported by policies. The provider had an effective system in place to ensure that all pathology results are actioned within 24 hours.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve it.

Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. There was a designated safeguarding lead and staff were aware of them. Regular safeguarding multidisciplinary meetings were held to discuss safeguarding concerns. Safeguarding registers for both children and adults were maintained. There were digital flags on the system for any safeguarding concerns.

The service worked with people to understand and manage risks. The service provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and knew of action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated. The practice had developed a triage sheet to support reception staff to navigate patients effectively to the right clinician or emergency services.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Contracts were in place to ensure the premises were maintained safely and appropriately. There was a business continuity plan in place which was monitored and reviewed.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

There were a range of clinical and non-clinical roles within the practice. We found training was up to date, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence. Safe recruitment practices were followed. The practice was a teaching practice and offered supportive placements for medical students. We found that the practice had an effective system of supervision evidencing discussions and learning outcomes to ensure safe practice and development of staff. Staff told us that there was an open-door policy, and we found evidence of clinical support for staff in patient medical records.

The service assessed and managed the risk of infection. They detected and controlled the risks and shared concerns with appropriate agencies promptly.

The practice had completed an infection prevention and control audit in line with the National Standards of Healthcare Cleanliness for clinical settings. Observational audits had also been completed, including hand hygiene. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

The service made sure that medicines and treatments were safe and met people’s needs and preferences. We saw medicines were managed safely.

During our review of the clinical system, we found that 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, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. Staff managed prescription 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 regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. 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, through our clinical searches we found patients were consulted with regarding any potential risk from medications. Our remote clinical record searches found safety alerts and recalls were managed well. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring.

Our remote clinical searches found that overall medicines were managed well, however, we saw that for some patients there was a lack of follow up of steroid use within recommended time frames. Following the assessment, the provider developed a new standard operating procedure which was implemented and searches of the clinical system for regular audits.

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 antimicrobials issued by the provider was lower than local and national averages. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment. For example, a recent audit of Hydroxychloroquine monitoring showed the practice had made appropriate referrals for ophthalmology. The audit provided a refresh on learning for staff and a refining of processes.