Crawley Road 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. This involved reviewing policies, speaking with staff, and undertaking observations while on site. The practice had systems, processes, and practices to safeguard people. Staff had the information needed to deliver safe patient care and treatment. There were arrangements for reviewing and investigating safety and safeguarding incidents and events when things go wrong.

People were protected and kept safe. Staff understood and managed risks. All staff knew who the safeguarding lead was. Clinical staff regularly had discussions during clinical meetings and the practice used system searches to follow up with patients who did not attend appointments. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes.

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.

The practice had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. The practice had a significant event and complaints policy and a reporting form that was accessible to all staff. Incidents were discussed during team meetings, and the learning outcomes were shared.

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

All staff knew who the safeguarding lead was. Safeguarding policies and procedures were available and accessible to all staff. The practice had monthly clinical meetings and regular discussions with local health and social care professionals, such as health visitors to support and protect adults and children at risk of significant harm.

Staff 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. During this assessment, we spoke with three patients. They told us they felt involved in their care and treatment.

The practice had a range of risk assessments in place, including legionella, waste management and general health and safety risk. Medical equipment was calibrated, and portable appliance testing was carried out to ensure the equipment was fit for purpose and in good working order.

Leaders 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 were a range of clinical and non-clinical roles within the practice.

There was a programme of learning and development in place, and they provided protected learning time and appraisals. Staff had undertaken updates and development activities to ensure their knowledge and skills were up to date. The provider made use of an online training tool for staff training.

We found that clinical staff were working within their areas of competence.

The premises were visually clean, hygienic, and well-maintained. Cleaning records confirmed regular schedules were followed. Clinical stock was in date, and sharps bins were managed appropriately. Staff demonstrated awareness of the infection prevention and control (IPC) lead, and up-to-date policies and procedures were accessible to all. All team members had completed role specific IPC training, including sepsis awareness, and the practice had addressed previous audit findings. However, our IPC specialist advisor noted loose wall seals in two clinical rooms, a potential infection risk, that had not been identified in the practice’s monthly IPC audits. Following the assessment the provider confirmed that the loose wall seals had been repaired.

Staff received regular training, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. They regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. Staff stored oxygen safely and completed required safety risk assessments. The provider had effective systems to manage and respond to safety alerts and medicine recalls.

Clinical staff described the practice's processes to ensure appropriate clinical oversight and explained how they monitored patients' health, including their use of high-risk medicines. We found that staff had good knowledge of current and relevant best practice and professional guidance. An effective system was in place to evidence the competence of non-clinical medical prescribers, including clinical supervision. The practice had appropriate prescribing policies and procedures. The provider held regular GP clinical meetings to discuss patient cases, share knowledge, review clinical practices and identify areas for improvement.

Overall, the remote clinical searches carried out by our GP specialist advisor demonstrated a high level of clinical governance and adherence to prescribing standards. However, there were areas for improvement. We identified 15 patients with asthma having had more than two issues of steroids in the last 12 months but had not been offered a steroid card (crucial for patients on long-term steroids to alert healthcare professionals during illness or stress). This issue had been identified during the practice’s previous inspection in 2023. Following the inspection the provider carried out an emergency steroid card audit, implemented a plan to contact the identified patients, and placed on an annual repeat cycle.

Additionally, we found that some patient consultations lacked objective findings (for example, blood pressure, temperature). Following the assessment, the provider informed us they had reviewed these cases and would discuss them in a clinical meeting to reinforce consultation guidelines.

During the clinical searches, we noted a hospital clinician’s failure to specify which day of the week a specific medicine should be taken per guidance. After raising this with the practice they initiated corrective action.

Antibiotic prescribing was in line with the local average in 3 of the 6 indicators, above the local average in two indicators and tending towards a positive variation in one indicator.