The Merton 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.

The service had a good learning culture and patients could raise concerns. Managers investigated incidents thoroughly. Patients were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of patients, 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 patients in planning any changes.

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. All staff including non-clinical were made aware of significant events.

They listened to concerns about safety and investigated and reported safety events. The significant event policy had been reviewed in November 2025. We saw a significant event log sheet available on the practice’s shared drive. Lessons were learnt to continually identify and embed good practice.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. Staff we spoke with indicated they were happy with the way the practice responded to and supported them when things went wrong. There were systems in place to ensure learning was shared.

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

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 patients support. We reviewed the complaints log, and it was managed in line with our expectations. Learning from incidents and complaints resulted in changes that improved care for others.

The service worked with patients 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 patients moved between different services. For example, the nurse told us about how she engaged with community diabetes and respiratory teams, ensuring any concerns were escalated in a timely way.

There were systems in place for processing information relating to new patients. The service worked with other providers to deliver shared care and when patients moved between services. Referrals and test results were managed in a timely way. All test results were actioned daily, the practice had dedicated staff, that checked all results. Results would be sent to GP who requested them, if the requesting GP was away, the results would be redistributed to a GP who was working that day.

The service worked with patients and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving patient’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 appropriately trained in safeguarding procedures. The practice maintained a list of vulnerable patients and acted on concerns working in partnership with other organisations.

All staff we spoke with demonstrated a comprehensive knowledge of safeguarding. All GPs, and nurses completed training to level 3. All other staff completed training to level 2. We saw separate polices that covered children and adults, these had been reviewed in November 2025.

The practice had quarterly meetings with the health visitors, they informed us, they make sure child immunisations were followed up.

The service worked with patients to understand and manage risks by thinking holistically. They provided care to meet patients’ needs that was safe, supportive and enabled patients to do the things that mattered to them.

The national GP patient survey data collected between December 2024 and April 2025 showed a total of 90% of respondents stating they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment. This was in line with the local average of 92% and national average of 91%.

The practice had access to an emergency trolley where they stored emergency medicines and equipment. Staff knew where to access the trolley.

Staff could recognise a deteriorating patient and knew of action to take. All staff had completed sepsis training. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

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. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed. There was a business continuity plan in place which was monitored and reviewed.

The practice had a risk register, and structured risk assessments were undertaken annually. For example, we saw fire, and health and safety risk assessments. We saw a certificate for Portable Appliance Testing (PAT) equipment dated April 2024, this was checked every 2 years. We saw certificates for calibration of equipment dated August 2025.

Fire drills were conducted every 6 months; fire alarm checks were done weekly. The practice had 3 fire wardens, and they had all completed fire warden training.

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 patients’ individual needs.

There were a range of clinical and non-clinical roles within the practice. We found training was up to date, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence. Safe recruitment practices were followed. We reviewed 5 staff records which demonstrated the practice had appropriate recruitment system and process in place. We reviewed a staff training matrix and reviewed 5 staff files and found all staff were up to date with role specific 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 practice had a designated infection, prevention and control lead and all staff had had relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

The practice had undertaken an infection prevention and Control audit between April to June 2025; all actions had been completed. We saw a hand hygiene audit had been completed in June 2025 and legionella risk assessment was done September 2025.

The service made sure that medicines and treatments were safe and met patients’ needs, capacities and preferences. They involved patients in planning, including when changes happened.

We reviewed several clinical searches in relation to medicines and patient monitoring and found that patients were being appropriately treated and monitored.

Staff involved patients in reviews of their medicines and helped them understand how to manage their medicines safely. Patients knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. Staff received regular training, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely. Staff followed protocols to ensure they prescribed all medicines safely, and ensured patients received all recommended medicines reviews and monitoring.

Medicines including controlled drugs were stored securely and at appropriate temperatures. We sampled a range of Patient Group Directions (PGDs) and these had been authorised as expected having signatures and dates on them.

Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. Waste medicines were recorded and disposed of appropriately including medicines returned by patients. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff followed established processes to ensure patients prescribed medicines with specific risks received recommended monitoring.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued by the provider was lower than local and national averages. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.