NPC North Tyneside – Spring Terrace

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 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 provider promoted a positive culture of safety, openness and learning. Staff felt able to raise concerns and were encouraged to report incidents, near misses and safety events. Systems were in place to investigate incidents and complaints, and learning was shared with staff to reduce the risk of recurrence and improve care. We reviewed complaints and found responses acknowledged issues raised, included apologies where appropriate and identified learning and actions to improve practice.

For example, learning regarding the importance of completing 3-point patient identification checks was shared locally and across the wider organisation following a patient safety incident. The practice also demonstrated learning from a significant patient safety incident by reviewing clinical processes, strengthening staff awareness and implementing actions to improve care for vulnerable patients. This included appointing a GP with a special interest, delivering additional staff training and reviewing relevant policies and procedures.

The provider 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.

There were systems in place for processing information relating to new patients. The provider worked in partnership with other providers to support coordinated care and seamless transitions between services. Referrals and test results were managed in a timely way.

The practice had systems and processes in place to identify and respond to safeguarding concerns.

Regular safeguarding meetings provided structured oversight; concerns were addressed appropriately, and information was shared with relevant agencies when required. Staff knew who the safeguarding leads were at each site and felt able to seek advice and support when needed.

The practice supported vulnerable people to access care safely and made reasonable adjustments where required. The provider's training expectations included Mental Capacity Act training and, for relevant clinical staff, Deprivation of Liberty Safeguards (DoLS) training completion.

The provider 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 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 provider detected and controlled potential risks in the care environment. They ensured equipment, facilities and technology supported the delivery of safe care. Contracts were in place to maintain premises, equipment and services. Health and safety risk assessments and audits had been undertaken, and identified risks had been addressed. A business continuity plan was in place and subject to regular review.

At 49 Marine Avenue, we identified that the accessible toilet did not have an emergency call bell or pull cord. In addition, some areas of the premises appeared dated and would benefit from redecoration. The building was an older property with limited storage space, and some staff-only areas behind the reception desk were being used for storage. These areas were not accessible to patients. Despite this, the premises were clean and functional. Leaders were aware of the limitations of the building and told us they had an ongoing programme of maintenance and improvement in place whilst exploring longer-term options for the site.

The provider generally ensured there were sufficient staff with the skills, experience and qualifications required to meet people's needs. However, we identified some gaps in training compliance and opportunities to strengthen training oversight. Learning disability and autism training was not included within the mandatory training matrix for all staff roles at the time of the assessment. We also found safeguarding adults training requirements had not been aligned to the expected level for all clinical staff roles, with some clinical staff assigned Safeguarding Adults Level 2 training within the training matrix where a higher level of training would ordinarily be expected for their role. Leaders monitored safeguarding training compliance and, during the assessment, provided evidence of an action plan to improve oversight. Following the assessment, leaders told us they had reviewed the training matrix, added learning disability and autism training to mandatory training requirements and updated safeguarding training requirements to ensure staff completed training appropriate to their role.

At the time of the assessment, some staff were also overdue Basic Life Support (BLS) training, which included sepsis awareness training. Compliance varied across sites, ranging from 61.9% to 87.5% for adult BLS training and from 63.2% to 87.1% for paediatric BLS training. Leaders told us this training had been scheduled for 22 July 2026 following several previous cancellations. Staff we spoke with understood how to recognise and escalate concerns relating to deterioration, including possible sepsis, and the practice used a care navigation tool to support risk identification. To provide additional assurance in the interim, practice managers confirmed that quick reference guidance on the recognition of sepsis and anaphylaxis would be shared with reception staff.

A range of clinical and non-clinical staff worked together to deliver care and treatment, and staff spoke positively about the support available to them. Safe recruitment processes were followed, and staff had access to training, supervision and appraisal.

Leaders maintained oversight of workforce capacity, sickness absence, professional registrations and revalidation requirements through regular workforce monitoring processes. The provider also had arrangements in place to manage workforce pressures and maintain service delivery, including cross-site support, overtime and locum cover where required.

Non-medical prescribers had access to a range of support mechanisms, including duty doctor support, daily huddles, case discussions, prescribing audits and appraisal processes. Whilst these arrangements provided oversight and support, there was no formal competency assessment process in place and individual competency reviews were not routinely documented.

The provider assessed and managed the risk of infection. Systems were in place to detect and control the spread of infection, and concerns were shared with relevant agencies when required. The practice had a designated infection prevention and control lead, and staff had received relevant training. Cleaning schedules were in place and followed, and infection prevention and control audits and risk assessments had been completed, with actions taken where required.

We saw examples of action taken in response to infection prevention and control audits. This included the provision of a sanitary disposal bin within the men's toilet facilities to support the needs of transgender individuals and patients managing continence concerns. Audit findings relating to unlabelled clinical waste bins, the availability of blood spill kits and the replacement of privacy curtains had also been addressed.

At 49 Marine Avenue, staff reported there was no dedicated staff room. Although alternative non-clinical areas were available for staff breaks, staff told us they sometimes washed cutlery within a clinical area. Leaders told us an alternative non-clinical sink was available for staff use and that staff would be reminded to use this facility.

The provider generally ensured that medicines and treatments were safe and met people's needs, capacities and preferences. They involved people in decisions about their medicines, including when changes were required. Staff supported people to understand how to use their medicines safely and what to do if their condition changed.

We carried out clinical searches as part of the assessment and found that the provider had systems to identify and manage potential medicines-related risks. In most cases, searches relating to long-term condition management demonstrated effective systems for reviewing and monitoring patients with ongoing health conditions.

However, we identified a small number of medicines-related issues. These included 37 patients (23.1%) prescribed medicines used to treat heart conditions and high blood pressure who required routine blood test monitoring. Following our review, the provider confirmed that 11 patients had already received the required monitoring through hospital services and the results had subsequently been downloaded into the practice record. A further 2 patients had appointments booked, reducing the number of patients requiring follow-up action to 24 (approximately 15% of the relevant patient cohort).

We also identified 7 patients aged 65 years and over prescribed a higher dose of an antidepressant associated with an increased risk of heart rhythm problems in this age group. In the records reviewed, there was limited documentation demonstrating that these risks had been considered or discussed.

A further search identified 266 patients (33%) out of a combined cohort of 797 patients aged 65 years and over prescribed anti-inflammatory medicines, or aged 75 years and over prescribed antiplatelet medicines, without documented gastroprotection to reduce the risk of stomach-related side effects. The provider immediately reviewed these patients and implemented a quality improvement programme. At follow-up, the number of patients identified had reduced to 201 patients (25%).

The provider acknowledged these findings, reviewed the affected patients and implemented actions to strengthen monitoring, prescribing oversight and clinician awareness.

Staff managed medicines safely and regularly checked stock levels, expiry dates and storage temperatures for medicines, including vaccines and emergency medicines. The provider had systems in place to manage medicines safety alerts and recalls and acted when prescribing risks were identified. However, prescription serial numbers were not routinely recorded, and prescription forms were found in a printer in an unused consulting room. Leaders advised they would review local processes for prescription security.

The provider also demonstrated a proactive approach to prescribing safety. Following emerging prescribing safety information relating to propranolol, clinicians completed a quality assurance review and shared learning across the organisation to support safe prescribing, medication reviews and improved documentation.

Our review of prescribing data showed that overall antibiotic prescribing was in line with expected levels. The practice also prescribed a lower-than-expected proportion of broad-spectrum antibiotics, demonstrating good antimicrobial stewardship and helping to reduce the risk of antimicrobial resistance.