Dr Rajiv Goel Also known as The Riverside 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

There was a proactive and positive safety culture, supported by openness and honesty. Safety concerns were actively heard, with incidents thoroughly investigated and appropriately reported. Lessons learned were used to inform and embed best practices across the service. Emergency management processes were robust, and safety netting measures were integrated into the triage system to mitigate clinical risks. Infection prevention and control were consistently monitored, with timely actions taken to safeguard individuals. The premises and equipment were safely maintained, and safe recruitment practices were followed.

A structured learning and development programme was in place to support staff in maintaining high standards of safety and care.

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

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 continually identify and embed good practice.

Safety was consistently treated as a top priority, supported by clear processes for reporting incidents, near misses, and safety events which included a significant event log and protocol. Complaints were systematically recorded and investigated, and when things went wrong, staff offered apologies and support.

The service worked collaboratively with people and healthcare partners to establish and maintain safe systems of care, where safety was actively managed and monitored. Systems were in place to process information for new patients, and the service worked effectively with other providers to support shared care and smooth transitions between services. Referrals and test results were handled in a timely manner.

Leaders and staff reported that a designated team was responsible for managing referrals through the NHS e-Referral Service. Staff monitored the system to ensure referrals to specialist services were accurately documented, included the correct information, and were processed without delay. Safety netting procedures were in place to ensure all patients were appropriately followed up. Routine referrals were monitored to confirm whether patients still required specialist input or if their condition had deteriorated.

Leaders also explained that they maintained oversight of workflow tasks to ensure timely responses. A system was in place to summarise patient records effectively.

The service showed a strong commitment to safeguarding, taking prompt action to protect individuals from abuse and neglect through effective collaboration with partners. Monthly internal meetings were held to discuss safeguarding issues, and children who missed appointments were actively monitored. Non-clinical staff understood how to report concerns appropriately.Robust systems and processes were in place to keep people safe, with a clear focus on improving lives while upholding the right to live free from harm, discrimination, and abuse. Safeguarding concerns were consistently shared in a timely and appropriate manner, and patient records confirmed that vulnerable individuals were flagged for staff attention.Staff were well-trained in safeguarding procedures, and policies were clearly understood and effectively implemented.

Staff worked with individuals to understand and manage risks holistically. They delivered care that was safe, supportive, and tailored to meet people’s needs.Emergency equipment was available and properly maintained. Staff were able to recognise when a patient’s condition was deteriorating and understood the appropriate actions to take. Patients were advised about risks related to their condition and were given guidance on what to do if their condition worsened.The service had a comprehensive suite of policies which addressed various risks, including fire, flooding, loss of computer or telephone systems, and staff shortages.

During our on-site assessment, we observed that the premises were clean, well- maintained, and conducive to safe care. The service had effective systems in place to monitor and comply with mandatory risk assessments, including fire safety and legionella testing, helping to ensure the safety of both patients and staff. Records confirmed that medical equipment was regularly maintained, calibrated, and tested.A business continuity plan was in place and subject to regular review to ensure preparedness for potential disruptions.

Patients confirmed the service was always maintained well; however, it was mentioned that the seating areas could be expanded to accommodate more patients.

The National GP Patient Survey, carried out from December 2024 to April 2025, received 136 responses. It found that 95% of patients had confidence and trust in the healthcare professional they saw or spoke to during their last appointment, compared to 90% locally and 93% nationally. The service had ensured that there were sufficient qualified and experienced staff who received effective support and supervision. Staff had worked well together to deliver safe care that met people’s individual needs, and the team had reported feeling supported by the leadership team, with their views being listened to. Staff were equipped with the necessary knowledge and skills to deliver safe, effective, and person-centred care, and the provider-maintained oversight to ensure training remained up to date and relevant.Staff recruitment practices were effective and followed policy. For one locum GP, the service appropriately used the Disclosure and Barring Service (DBS) to perform a live status check in September 2024, ensuring current safeguarding assurance before engagement. This demonstrated effective oversight of recruitment records. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

There was a diverse mix of clinical and non-clinical staff within the service.

The service assessed and managed the risk of infection effectively. Risks were identified, controlled, and processes were in place to share concerns promptly with relevant agencies. Cleaning schedules were in place and followed. The practice had two designated Infection Prevention and Control (IPC) staff members; however, there was uncertainty regarding who the infection control lead was. The practice manager identified the nurse as the lead, while the nurse stated it was the practice manager. Furthermore, the training completed by the staff members designated for IPC responsibilities (both held up-to-date level 2 training) was not considered by the inspector to be at a sufficient level for the strategic oversight and leadership required of an IPC lead in the service. This was promptly addressed by the provider, who arranged for the relevant staff to undertake advanced IPC training following the assessment.

Risk assessments and audits were completed, with actions taken to mitigate identified risks. People we spoke with told us they found the premises clean and tidy and had no concerns relating to IPC.

Leaders described the service's processes to ensure appropriate clinical oversight and told us how they monitored patients' health, including their use of high-risk medicines (such as warfarin, methotrexate, and lithium). We found that staff had good knowledge of current and relevant best practice and professional guidance.

There was an effective system to evidence the competence of non-clinical medical prescribers, including clinical supervision. The service had appropriate policies and procedures to govern prescribing effectively. The provider held regular GP clinical meetings to discuss patient cases, share knowledge about new medical information, review clinical practices, identify areas for improvement, and ultimately enhance the quality and safety of patient care within a service.

Staff received training in medicines management and reported feeling confident in handling the storage, administration, and documentation of medicines. They held the necessary authorisations to administer medicines, including Patient Group Directions and Patient Specific Directions. Medicines-related stationery was managed securely, and staff followed established protocols to ensure safe prescribing practices.

The service ensured that medicines and treatments were safe, person-centred, and aligned with individuals’ needs, capacities, and preferences. People were actively involved in planning their care, including when changes to their medicines occurred. Staff supported patients in understanding and managing their medicines safely and knew who to contact if their condition worsened or unexpected symptoms arose.

Staff were regularly trained and assessed for competency in medicines optimisation. Prescription stationery was stored securely, and medicines, were kept at appropriate temperatures. Stock levels and expiry dates were routinely checked.

The provider had robust systems in place to manage safety alerts and medicine recalls. Staff took proactive steps to ensure prescribing was appropriate and aimed at optimising care outcomes, including the responsible use of antibiotics. Prescribing data reviewed during the assessment supported this, showing that the provider issued fewer hypnotics and psychotropics compared to local and national averages.

A programme of regular clinical audits focused on prescribing practices, aiming to continuously improve care and treatment.

As part of the assessment, a series of clinical record searches were carried out by a CQC GP Specialist Advisor, with the provider’s consent. These searches aimed to assess whether the service was delivering care and treatment in line with current legislation, standards, and evidence-based guidance. We found that medicines were prescribed safely, and medication reviews were up to date.

Initially, no risk assessment had been conducted to justify the decision not to stock resuscitation equipment, namely oropharyngeal airways, portable suction, and supraglottic airway devices. Similarly, three emergency medicines were not stocked, and this decision was unsupported by a formal risk assessment. Upon identification of these gaps, the provider immediately implemented corrective actions by completing risk assessments for their decision.