South Westminster Centre for Health Also known as South Westminster 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 looked for evidence that people were protected from abuse and avoidable harm. This is the first inspection for this service since its registration with CQC. This key question has been rated as Good.

This service scored 69 (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 positive culture of safety based on openness and honesty. However, systems were not always working as intended and we found that one recent incident had not been reported to HCL. The service leaders and managers always listened to concerns about safety and investigated and reviewed all reported safety events. Lessons were learnt from reported events to identify and embed good practice.

Staff understood their duty to be open when things went wrong and were encouraged to report incidents. The provider had processes for staff to report incidents, near misses and safety events. Incidents were reported to the board and reviewed for patterns. Learning was fed back to clinical staff via a regular newsletter and email communications from the relevant operational managers. However, we identified an incident which had not been reported and which we believed met the criteria for consideration as the running of the service had been affected. The incident involved a person who arrived for a primary care consultation but their symptoms required immediate AE attendance. The incident itself had been managed well when it occurred but the circumstances had not been reviewed for potential learning. More generally, staff told us there was an open culture, and that safety was a top priority. There was a system to record and investigate complaints, and when things went wrong, affected people received a written apology and support if appropriate. Learning from incidents and complaints resulted in changes that improved care for others.
 

The service worked with people and healthcare partners to establish and maintain safe systems of care.

There were clear criteria for GP practices to refer people appropriately to HCL services. For example, the access hubs only treated adults with acute conditions. HCL monitored referrals to its services to ensure these were appropriate and that practices understood how to make use of these resources for the benefit of their population. Clinicians working in the diagnostic clinics had access to specialist consultant advice and referrals and test results were managed in a timely way.
 

There were systems in place to safeguard people’s right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. The service acted on concerns working in partnership with other organisations, for example, always sharing information with the person’s GP practice.
 

The service worked with people to understand and manage risks. They 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 at the South Westminster Centre for Health and at the GP practices used by the service to run access hubs. Staff could recognise a deteriorating patient and knew of action to take. People were advised on risks related to their condition and actions to take if their condition deteriorated. The service provided a reference sheet in all locations with key information for clinicians including the location of emergency equipment and medicines. However, clinicians working at a location for the first time (including out of hours) were not always physically shown the location and access arrangements for emergency equipment and medicines.
 

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. Health and safety risk assessments and audits were undertaken and identified risks were addressed. 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 to provide safe care that met people’s individual needs.

The organisation, structure and roles were clearly defined. There were a range of managerial, clinical and non-clinical roles within the service. The access hubs included clinicians who were either employed or contracted on a sessional basis. Clinicians working in the diagnostic services, for example, the dermatology clinic, were appropriately accredited with access to peer support and consultant advice. Safe recruitment practices were followed.

The service had a clear schedule of required training tailored to role. However, the management team did not have an effective system to track completion of training and this was being managed at team leader level. We were told that a new system was being introduced within the next two months which would electronically provide this oversight. At the time of the assessment, we could not be fully assured that staff had completed required training in line with expectations although staff we spoke with were able to provide evidence of completion and we did not identify any gaps. The learning needs and development of employed staff were being managed appropriately, and staff were working within their agreed areas of competence.
 

The service assessed and managed the risk of infection. They detected and controlled the risk of infection spreading and had mechanisms to share concerns with appropriate agencies and people’s GP practices promptly.

The service had a designated infection, prevention and control lead and staff had received relevant training. Cleaning schedules were in place and followed at all locations used. 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, capacities and preferences. They involved people in decisions, including when changes happened.

Staff understood the protocols relating to medicines optimisation, and described how they managed the storage, prescribing and recording of medicines. Staff managed prescription stationery appropriately and securely. They followed protocols to ensure they prescribed medicines safely. We saw that clinicians took steps to ensure they prescribed medicines appropriately to optimise care outcomes. There was a system to manage national patient safety alerts which were directed to the clinical leads and cascaded for audit and action. However, at the time of the assessment, we found that national patient safety alerts were not always acted on consistently. For example, we found that not all patients prescribed nitrofurantoin (an antibiotic typically used to treat urinary tract infection) had been updated on potential complications as outlined in a national alert. Emergency medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for the emergency medicines, vaccines, and controlled drugs. Medical oxygen was stored safely and clearly signed. There was a programme of regular audits of clinical notes covering the access hubs and audits of prescribing within the diagnostic clinics.