Prestbury Medical Practice

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.

At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.

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.

We looked for evidence that people were protected from abuse and avoidable harm.

The service demonstrated a proactive and positive safety culture. Leaders and staff listened to safety concerns, and incidents were investigated and reported appropriately. Lessons were learned to continually identify and embed good practice.

Information on how to raise a concern was clearly displayed in the premises and on the service’s website. Patients could raise concerns in several ways, including by email, letter, complaint form or verbally.

Staff were able to clearly explain the process for raising concerns when things went wrong and how they would support patients throughout this process.

There was an effective system in place to record and investigate complaints. Learning from incidents and complaints was shared with staff, and there was evidence that this had been used to improve patient care. Responses to complaints and concerns were detailed and honest. The examples reviewed during the onsite assessment showed that complaints had been managed effectively and the service was open to feedback when things had gone wrong.

There was a good level of incident reporting, which included supported learning across all roles where appropriate. Staff were encouraged to report any event that could be learnt from and records showed that reviews, discussions and actions were documented, shared and completed.

Representatives from the Patient Participation Group (PPG) said the provider took concerns seriously and made improvements to the service.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service was part of the Primary Care Network (PCN) and attended regular meetings with other local services to share and discuss information about patient care and treatment. This included discussions about people on the service’s palliative care register.

Referrals were well managed, with systems in place to provide assurance. For example, two-week wait referrals were tracked to make sure they had been actioned and completed.

Test results and tasks were managed in a structured way, with systems in place to ensure urgent results were reviewed and actioned promptly to ensure peoples care and treatment requirements were met.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve it. They concentrated on improving people’s lives while protecting their 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, understood by staff, and supported by appropriate training. The service maintained a register of vulnerable patients and acted on concerns by working in partnership with relevant organisations.

Staff showed a good understanding of safeguarding and could give examples of how their roles and responsibilities helped keep people safe. There was a safeguarding lead in place who had the knowledge and experience to support staff and respond to queries and concerns.

The service worked with people to understand and manage risks by thinking holistically. 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 well maintained. Staff could recognise a deteriorating patient and knew what action to take. There were electronic prompts and visual alerts to support staff and patients in identifying serious symptoms, such as those linked to sepsis and stroke.

Patients were given advice about risks related to their condition and what to do if their health worsened.

The service understood risks and could show measures in place to reduce them. Health and safety risk assessments were available during the onsite assessment, and the provider was able to demonstrate effective oversight of risks. A review was also underway to ensure appropriate risk assessment documentation was in place for all areas of risk affecting the service and patients.

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. The environment was clean and maintained. Audits and routine checks were carried out and staff understood their responsibilities and processes to keep the environment safe. There were risk assessments in place for the control of hazardous substances (COSHH). A health and safety risk assessment, including fire risks had been completed in March 2026. Systems were in place for the regular checks of fire alarms, extinguishers and fire evacuation procedures with weekly checks carried out around the building.

Staff had been provided with training in health and safety related topics such as fire safety, infection control, basic life support and resuscitation training.

A sample of equipment was checked and demonstrated regular calibration and electrical items were PAT (portable appliance testing) tested. The latest testing of equipment had been completed in September 2025.

There was a business continuity plan in place which was monitored and reviewed. Staff knew where to access the plan and when it should be implemented.

Clear signage around the building supported people and staff in the event of an emergency evacuation.

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 was a clear and detailed induction process in place. This included safe recruitment checks, as well as support and information provided both verbally and in writing. We saw an informative and well-structured induction pack for staff, locums and trainee GPs.

Systems were in place to monitor staff performance, including regular discussions as part of clinical supervision. There was regular supervision for non-medical prescribers and trainee GPs, and systems supported the monitoring of all staff.

A review of training records identified that evidence of completed training was not consistently available for all staff. For example, one staff member’s record did not include evidence of training in infection prevention and control, manual handling, or chaperoning.

Following the onsite assessment, the service provided evidence that the training had been completed within the required timeframes. The record-keeping system had also been updated to ensure all required training for each role was clearly documented

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

The service had a designated infection prevention and control (IPC) lead. Staff had completed training and relevant updates were shared through newsletters, emails and meetings. Evidence of staff immunisation status was seen and documented as required.

Audits had been completed and staff were aware of their responsibilities in relation to IPC and how to keep people safe.

Measures were in place to keep people safe and reduce the risk of infection, such as a process for specimens and waste management. There was a range of Personal Protective equipment (PPE), such as gloves and aprons, in various key locations and all clinical rooms.

There were cleaning schedules and guidance in place. A sample of cleaning records showed that cleaning was completed routinely and recorded.

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They did involve people in planning.

Staff took steps to make sure medicines were prescribed appropriately to support good care outcomes. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobial medicines prescribed by the service was in line with national averages. Antimicrobial medicines, which include antibiotics and antivirals, are medicines which reduce infections caused by different microorganisms.

Medicines were stored securely and at appropriate temperatures. Fridge temperatures were routinely monitored and recorded electronically, any gaps could be identified and assurance provided by downloading data from a second temperature recording tool.

We carried out a sample check of medicines stored in the fridge and medicine cupboard. Of the 10 items checked, 9 were in date. The item found to be out of date was no longer in use, and the service took immediate action to dispose of it safely.

We carried out remote searches of clinical records as part of our assessment to check how the service monitored patients’ health. The searches identified 73 patients with asthma who had received a course of steroids in the last year to reduce inflammation in the lungs. Of the 5 randomly selected records reviewed, 2 did not have a documented review for a combination inhaler in line with national guidelines.

The provider had already enrolled in the Excellence in Asthma programme to support people with poorly controlled asthma. Following our review they also provided evidence of learning and improvement actions, including staff education sessions, support from the local asthma clinic in secondary care, and the use of an alert system to identify patients at increased risk related to asthma.

We carried out clinical searches to assess how well the service reviewed patients who were routinely prescribed medicines. We reviewed records for patients prescribed levothyroxine, a medicine used to treat an underactive thyroid. All 5 randomly selected records demonstrated that appropriate reviews had been completed or that patients had been contacted to arrange a review.

We also assessed how the service responded to Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts. This included an alert relating to patients aged over 65 years prescribed citalopram. Of the 5 records reviewed, 2 did not demonstrate that risks had been discussed with patients or that this had been appropriately recorded.

The service used Patient Group Directions (PGDs) to support the safe administration of immunisations. Staff using PGDs demonstrated a good understanding of their use, and documentation had been appropriately authorised and signed.

We reviewed a sample of completed medicine reviews and found these were clearly documented and completed to a high standard.