Hatch End 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 66 (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. During our site visit we saw that learning from significant events was shared with staff via emails. There was a system to record and investigate complaints. There was a duty of candour policy in place, and this was followed when appropriate.

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 patients moved between different services. There were efficient systems in place for processing information relating to new patients as well as those moving across health and social care pathways. 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. The service had an adult and child safeguarding register. During our site visit we saw that patients had appropriate alerts and codes on the practice database. Safeguarding concerns were discussed during relevant meetings and recorded. Safeguarding policies were in place and staff knew where to access these.

However, during our site visit, we saw that two members of staff, which included a nurse, did not have the appropriate level of safeguarding for their roles in accordance with the intercollegiate guidelines.

The service worked with people to understand and manage risks. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. During our on-site visit we saw that emergency equipment was available and well maintained.

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. A Fire risk assessment, Disability Access Risk Assessment and Legionella Risk Assessment had also been undertaken. 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. Safe recruitment practices were followed. Appraisals were seen for most staff we looked at. During our site visit, we found gaps in training and recruitment files for staff. This included some staff members not having Learning Disability and Autism training and the appropriate level Safeguarding training for their roles. The service, after the site visit, provided evidence that the identified shortfalls had been or were in the process of being rectified.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading. The service had a designated infection, prevention and control lead who all staff we spoke with were able to identify. All staff had completed their relevant infection prevention and control training. Cleaning schedules were in place and followed.

People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. During our site visit we saw that staff managed prescription stationery appropriately and securely. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. The service had medical oxygen and a defibrillator for use in a medical emergency.

However, we found some areas for improvement. We found that, contrary to national guidelines, there was not a consistent follow up within a week of steroids being prescribed for some patients with asthma who had been prescribed 2 or more courses of rescue steroids. The medicine reviews for some of these were not detailed which could not guarantee that the recording clinician had objectively reviewed all of the medicines.

We found some patients, who were prescribed medicines used to prevent and treat blood clots, were overdue monitoring in the last year. We found that 3 older patients on medicines used to treat depression were on high dose without being informed of the risks. Records for this did not show evidence of patients being informed of risks and medication reviews for these were not detailed. The search also showed that medicine reviews did not include a review of diabetic medicines. The service demonstrated that they had followed up, after the assessment, on all our findings from our clinical searches.