Central 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

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 people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. 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. Generally staff managed medicines well, and involved people in planning any changes however, clinical searches undertaken identified a medicines safety risk in 2 out of 10 searches, this was immediately addressed when it was raised with the practice.

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 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.

The practice had a learning event policy reviewed in April 2025 and a complaints policy reviewed November 2023 which was reviewed every 2 years. There were processes for reporting, recording and acting on incidents and staff carried out learning event analysis (LEA). They had a culture of no blame but reflect and learn. Staff told us they could raise concerns and report when things went wrong. Staff told us that incidents were discussed during team meetings, and the learning outcomes were shared with staff.The practice also had a duty of candour policy in place.

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 people support. Learning from incidents and complaints resulted in changes that improved care for others. The practice had effective systems in place to manage and respond to safety alerts. We saw the practice had undertaken a range of clinical audits which demonstrated quality improvements for patients, for example audits looking at steroid use and the risk of osteoporosis and early onset type 2 diabetes.

The service 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. The service had effective systems in place to ensure information was shared across teams and agencies, enabling the delivery of safe, coordinated care. Staff gave examples of patients on diabetes pathways and working closely with the local partners to care for patients on the palliative care register. The advanced nurse practitioner ANP conducted numerous blood tests for diabetic reviews. The ANP screened all the results and tailored individual conversations with each patient including how best to move forward.The practice was involved in numerous projects including a frailty project and end of life care project.
The practice was running and hosting a paediatric together clinic, they informed us this helped to improve the transition between primary and secondary care and pathways for patients.

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. Clinicians processed results daily; there was a rota to cover staff who were on leave.

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 appropriately trained in safeguarding procedures. Staff were aware who the safeguarding lead was and how to escalate concerns. All staff (clinical and non-clinical) had completed the appropriate levels of safeguarding training.

The practice informed us they were 1 of only 3 Merton practices who were fully Identification and Referral to Improve Safety (IRIS) accredited at the time of the inspection.
Safeguarding audits had been undertaken which demonstrated quality improvement for example the practice ensured they advised parents about Infant crying is normal and will stop (ICON ) at the 8 week baby check with 100% compliance.

The practice proactively engaged with safeguarding reviews attending meetings where possible and where not possible providing comprehensive reports.
Regular meetings were undertaken with their link health visitor where safeguarding and complex children were discussed.

The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations. The safeguarding policy had been reviewed August 2025. There were safeguarding registers for both children and adults. Staff we spoke with demonstrated they had a good understanding. We saw monthly meeting minutes where the practice discussed cases with the health visitor. Safeguarding was included as standard agenda item in clinical meetings.

The service 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.

Data from the GP Patient survey 2024 showed a total of 87% of respondents were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment. This was slightly below the local average of 92% and national average of 91%. During this assessment we received feedback about the practice. None of the respondents gave negative feedback about their level of involvement in decisions about their care and treatment.

Emergency equipment was available and maintained. Equipment was located in an accessible place and all staff were aware of where it was kept. Staff could recognise a deteriorating patient and knew of action to take. All staff had completed sepsis awareness training. Overall patients were advised on risks related to their condition and actions to take if their condition deteriorated. Clinical searches identified that some patients were not always monitored safely and in line with evidence-based guidance, however this concern was addressed once we raised it. For example 1 patient was overdue renal function monitoring, 1 patient with possible diabetes who had not responded to a follow up blood test request and 5 patients on NSAID/antiplatelet medication who did not have a documented offer of or prescription for a PPI (gastroprotection).

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

The practice premises owners included one of the current partners.

Contracts were in place to ensure the premises were maintained to keep everyone safe. The maintenance and upkeep of the building internally and externally was good.

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. We saw weekly fire alarms checks were done and fire drills were conducted every 12 months. A fire risk assessment was done in July 2025 and the practice had trained 2 fire wardens. A health and safety risk assessment was done in July 2025, all actions had been addressed. Electrical, gas and Legionella checks had all been done in the last 12 months.

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.

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, there were no concerns, all files had the necessary recruitment checks. This included signed contracts, references, proof of identity and Disclosure and Barring Service (DBS) checks All staff (clinical and non-clinical) were up to date with role specific training. Non-medical prescribers informed us they had regular supervision from lead GPs, where prescribing history was checked and was discussed at length during appraisals. Annual audits were undertaken as part of clinical supervision.

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 facilities and premises were clean, and systems were in place to prevent the spread of infection. Personal protective equipment (PPE) was well stocked and placed appropriately throughout the building.

Cleaning schedules were also in place for equipment such as nebulisers, blood pressure monitors and weighing scales. Staff told us any equipment used was cleaned immediately after use.

An infection control audit was done August 2025 the practice identified some minor actions which had been addressed. The cleaners had a cleaning schedule and check list of what needed to be completed at each visit. We saw cleaning schedules that were signed and dated.

The service generally made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Overall they involved people in planning, including when changes happened.

Clinical searches were undertaken and out of 10 searches related to medications there were 3 areas identified which needed improvement. For example, 1 patient did not have blood monitoring done despite attempts to contact them, 1 patient was overdue a renal function check by a few days which is recommended every 6 months, once we raised this with the practice, the practice informed us they contacted the patient who then had their check done a few days after the inspection.

Out of 10 of clinical searches undertaken 1 search identified patients on medicines used to treat cardiovascular disease of whom around 30 patients did not have a coded documented discussion or a prescription for a gastro-protective medicine recommended for their age group.

We saw the practice had undertaken comprehensive, detailed medication reviews.

Overall staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People 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 people received all recommended medicines reviews and monitoring.

Medicines including controlled drugs were stored securely and at appropriate temperatures.

Daily records of the maximum and minimum temperatures were recorded. Staff were aware of what to do if any fridge had temperature readings outside of the required range. All fridges were lockable to ensure only authorised staff could access them.

Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs.

There was a dedicated member of staff responsible for overseeing this task. Appropriate arrangements were in place if this person was on leave.

All Patient Specific Directions (PSDs) we looked at were in date and appropriately authorised). PSDs are used to authorise health care assistants (HCAs) to administer medicines.

All Patient Group Directions (PGDs) we looked at were in date and appropriately authorised. PGDs allow some registered health professionals to supply and/or administer specified medicines to a pre-defined group of patients, without them having to see a prescriber.

Waste medicines were recorded and disposed of appropriately. 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 people 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.