RAAM London Limited

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 Requires Improvement. At this assessment, the rating has changed to Good.

At our previous inspection we identified concerns about the way the service managed safety risks. More specifically, we identified gaps in the systems in place for managing safeguarding concerns; staff recruitment; and in the management of environmental risks. Immediately after that inspection, the provider submitted evidence of actions taken to improve. At this assessment, we found that the service had maintained these improvements. There were now effective systems in place to manage risks.

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 positive culture of safety, based on openness and honesty. They listened to concerns about safety and had systems to investigate safety events. Lessons were learnt to continually identify and embed good practice.

Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the team discussed and learnt from any clinical issues, complaints and feedback or staff concerns. Staff told us that there was an increasingly open culture within the service and that safety was a visible priority.

There was an improved system for staff to report incidents, near misses and safety events. There had been no serious clinical incidents over the previous 12 months. 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 to establish and maintain safe systems of care, in which safety was managed or monitored. Most people who used the service did not require referral and completed their treatment within the service.

Test results were managed in a timely way. There was continuity of care for people who needed or wanted this. There were systems in place for processing information relating to new patients. The service shared information with the person’s NHS GP if they consented to this.

The service worked with people and other organisations to safeguard people from the risk of abuse or neglect. The service had systems in place to share concerns quickly and appropriately.

Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. Since our previous inspection, the service had clarified the safeguarding referral process and staff were confident they could escalate concerns to the correct authority promptly. The clinicians and staff were aware of the potential risk of abuse and understood their responsibilities to escalate any concerns without delay.

The service worked with people to understand and manage risks. They provided care to meet people’s needs that was safe and supportive.

Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and knew of action to take. The team simulated an emergency situation several times a year to test their response. People were advised on risks related to their condition and actions to take if they were unhappy or had any concerns about the outcome of their treatment.

The service detected and controlled potential risks in the clinical 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 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 were being managed appropriately, and staff were working within their agreed areas of competence. Safe recruitment practices were being followed.

The service assessed and managed the risk of infection.

The practice had a designated infection, prevention and control lead and all staff had received relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks. The doctors followed a documented aseptic protocol when carrying out surgical procedures.

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.

At the time of the inspection, the doctors were prescribing a narrow range of medicines. They did not prescribe medicines that required ongoing monitoring or controlled drugs. Where there was a different approach taken from national guidance there was a clear rationale for this that protected patient safety. The service monitored national patient safety alerts to ensure any relevant guidance was implemented.

The doctors advised people on how to manage any 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 training and were confident managing the storage and recording of medicines. Staff managed prescription stationery appropriately and securely.

Medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments.