Mayfield 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.
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. 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.

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 worked with other providers to deliver shared care and when patients moved between services. Referrals and test results were managed in a timely way.

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. The practice maintained a list of vulnerable people and acted on concerns. They held monthly meetings where they reviewed the child protection register. The service worked in close liaison with other professionals and agencies.
 

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.
Emergency equipment was available and maintained. Staff were trained to recognise a deteriorating patient. They received training in critical areas such as sepsis, cardiopulmonary resuscitation, and anaphylaxis to ensure they could provide the necessary support where appropriate. Furthermore, patients were advised on the risks related to their conditions and the necessary steps to take if their conditions deteriorated.
 

The service did not always detect and control potential risks in the care environment. During our assessment of the service, we identified some safety concerns, such as a missing emergency pull cord in the accessible toilet, an overdue review of the fire register procedure, and an overdue electrical installation condition report. When the provider was informed of these issues, they addressed the concerns swiftly.
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 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.
 

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 were followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.
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 medicines were prescribed safely and that patients received all recommended reviews and monitoring. In recent years following concerns about Short-Acting Beta-Agonist (SABA) overuse, the practice implemented several measures to improve prescribing and asthma management. A text message screening system was introduced to identify poorly controlled patients before their annual review, and a new Standard Operating Procedure (SOP) ensured inhaler requests were moved to acute prescribing for doctor oversight, with reminders sent to book reviews. Additionally, the practice participated in a local scheme where a clinical pharmacist reviewed SABA-only patients in dedicated clinics to initiate Anti-Inflammatory Reliever (AIR) therapy, which combines a bronchodilator with a low-dose inhaled corticosteroid for symptom relief, or Maintenance and Reliever Therapy (MART), which uses a single inhaler containing a long-acting bronchodilator and an inhaled corticosteroid for both daily maintenance and symptom relief. During patient record reviews carried out as part of our inspection, we identified some coding errors. Once staff became aware, they corrected these errors and used the findings as an opportunity to review and improve coding practices within the service.
Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. 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. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.