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

At our last assessment, we rated this key question as Requires Improvement. At this assessment, the rating has changed to Good.

At our previous inspection we identified concerns about the way the service managed people’s medicines and safe prescribing. At this assessment, we found that the service had improved. There were now effective systems in place to implement medicines safety alerts; to manage people who were prescribed medicines requiring ongoing monitoring and to ensure that non-prescribing staff were correctly authorised to administer medicines as appropriate to their role.

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 and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to identify and embed good practice.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical issues. 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, for example, in one case, a person had queried the factual accuracy of some information they had been given in a consultation. The staff team discussed the case in a team meeting, shared the correct information and additional training was provided to minimise the risk of this happening again.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They aimed to provide continuity of GP care when appropriate and to advocate for people when they moved between different services.

There were systems in place for processing information relating to new patients.

Referrals and test results were managed in a timely way and allocated to the appropriate team member the same day. There was a duty doctor system and the duty doctor reviewed all results when the person’s named GP was away. Urgent referrals were monitored and included a call to the person to check they had received or attended their appointment.

The service had moved to a system of ‘triaging’ appointments and other clinical requests (such as ‘fit notes’). One of the GPs (the allocated ‘duty doctor’) was located in the same area as the reception team for the first hour of each day when most appointment requests came in so they were available to assist with more complex or urgent cases. Leaders and staff, including reception team members, told us that they benefited from having access to clinical expertise when ‘triaging’ people to be seen by the appropriate health professional. The reception team had been trained and had access to reference material to support the triage process.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. 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 and known to staff, who were trained in safeguarding procedures to the appropriate level for their role. The service maintained a list of vulnerable people and acted on concerns working in partnership with other organisations. The service reviewed the lists to ensure they were up to date.

The service worked with people to understand and manage risks by thinking holistically about people’s health and well-being needs. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People were advised on risks related to their condition and actions to take if their condition deteriorated.

Staff could recognise a deteriorating patient and knew of action to take. Emergency equipment was available and maintained and staff were trained on basic life support. The service had recently successfully managed a potential medical emergency on the premises and staff had followed the correct procedures.

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

Health and safety risk assessments and audits had been undertaken, for example, a fire safety risk assessment had been completed in March 2025; a health and safety risk assessment in May 2025 and a Legionella risk assessment in May 2025. Equipment calibration and portable appliance electrical safety testing was carried out annually. The managers took action to address concerns identified in recent risk assessments. For example, they had implemented periodic fire-drills (including evacuation) and were liaising with the landlord on upgrading the fire door protection. The most recent drill had been carried out the week before our assessment. 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.

Service leaders had increased the clinical staffing capacity since our previous inspection, recruiting 2 more GPs. The service had developed an urgent primary care team (including advanced practitioners and paramedics) who saw people with more urgent problems that did not require GP input. The partners carried out clinical note audits across the clinical team as part of their oversight of quality assurance and fed back any areas for improvement to the individuals concerned. All staff (including salaried GPs) had an internal appraisal.

We found training was up to date; the learning needs and development of staff were being managed appropriately; and staff were working in their agreed areas of competence. Safe recruitment practices were followed. The service arranged regular protected learning time sessions which could cover updates, suggested topics of interest, case review or time to complete mandatory training.

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 was complying with appropriate regulations and following relevant guidelines in relation to infection prevention and control (IPC). The service had a designated IPC lead and all staff had had relevant training. The service carried out minor surgery and had appropriate facilities to carry out this work and an aseptic technique protocol, in line with NHS guidelines, for reference. (An aseptic protocol sets out the procedures in place to prevent the transfer of harmful microorganisms during invasive clinical procedures, such as minor surgery.The risk of infection or contamination is minimised by following the protocol.)

Cleaning schedules were in place and followed and were under review at the time of the inspection due to recent changes in the national guidelines. Risk assessments and audits were completed (August 2025), and actions taken to mitigate risks identified. For example, the provider had recently disposed of some waiting room chairs and a trolley which were no longer in good condition.

We found that the service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes were made to their medicines. The service had improved its management of medicines since our previous inspection.

We carried out remote searches of the clinical records system to evaluate whether clinicians were prescribing a range of medicines safely. Clinicians followed safe prescribing protocols. People were informed about what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms when taking prescribed medicines.

People prescribed medicines with specific risks were now being monitored in line with recommendations. This had improved since our previous inspection. There were also processes in place to follow up people who did not attend for monitoring. For example, to safely reduce prescription amounts in this situation to encourage patients to attend for necessary monitoring. Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely.

The provider now had effective systems to manage and respond to safety alerts and medicine recalls. This had improved since our previous inspection. One of our searches identified people prescribed a particular combination of medicines typically used to treat high blood pressure. These people should be monitored in line with guidelines published in a national safety alert due to a risk of complications. Our search identified those people prescribed these medicines who were due blood tests but where the results were not yet recorded on the system. We looked at 5 cases in detail and found in each case that the person was only recently overdue monitoring and the service had already contacted the person to book the blood tests.

Staff who were qualified to prescribe (including non-medical prescribers) were confident about their agreed scope of professional practice and had access to advice and support as required. Non-prescribing staff who were administering medicines were now correctly authorised to do so through the use of patient group directions (PGDs) or patient specific directions (PSDs) as appropriate to their role. The management of PDGs and PSDs had improved since our previous inspection.

Staff received regular training on medicines optimisation. Staff were confident managing the storage, administration and recording of medicines. Prescription stationery was monitored appropriately and securely. Emergency medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates of emergency medicines and vaccines. Medical gases, such as oxygen were stored and labelled safely.

Clinicians prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the service’s prescribing rates of antibiotics, hypnotics and, the controlled drugs gabapentin and pregabalin, were statistically in line with the respective national averages. (Over-prescribing of these medicines is associated with harm). The service carried out regular clinical audits of prescribing that focused on improving care and treatment.