Bridge Road 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.

We assessed all quality statement from this key question. At our last assessment, we rated this key question as good. The rating remains good following this assessment.

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. Processes were in place for staff to report incidents, near misses and safety events. The provider listened to concerns about safety and investigated and reported safety events. Staff felt there was an open culture, and that safety was a priority.

The provider investigated incidents and complaints, and held regular clinical meetings where the learning from these was shared and discussed. Feedback from staff indicated that the learning from complaints and incidents was not always clearly communicated in wider team meetings. The provider took action to review the effectiveness of meetings across the wider team and had introduced a weekly staff huddle in response to this feedback.

Staff told us they were supported to identify their training needs and protected learning time was provided for them to undertake training, learning and professional development. Training was provided within the service and through attendance at locality wide training and educational events.

The provider worked alongside other stakeholders and worked within the Primary Care Network (PCN) to develop services.

Feedback from people who used the service was used to learn and make improvements.

The provider worked with people who used the service and healthcare partners to establish and maintain safe systems of care. There were systems and processes to share information with staff and other agencies to enable them to deliver safe care and treatment. The service worked with other providers to deliver shared care and when patients moved between services.

Feedback from people who used the service indicated they felt involved in decisions about treatment pathways and they reported prompt follow up care.

Members of the staff team were aware of local services and support networks that they could refer patients to in order to support them with their needs and to prevent ill health. Reception staff had been trained in care navigation to direct patients to the most appropriate service or services to meet their presenting needs.

Regular multi-disciplinary meetings were held where the needs of patients with more complex needs or those approaching the end of life could be discussed.

Clinicians followed care and treatment pathways for treating and referring patients to other services. Referrals to secondary or specialist care were made promptly, and checks were in place to ensure that patients who were referred under the two week wait rule for suspected cancer had received an appointment. Correspondence from secondary care such as discharge letters/summaries was processed effectively and timely.

The service worked to safeguard people from the risk of abuse. This included working with partner agencies. There were systems and processes to respond when it was suspected that people may be subject to abuse or neglect.

Staff had completed safeguarding training at a level that was appropriate to their roles and responsibilities. Staff had a clear understanding of safeguarding and were able to tell us who the responsible lead for safeguarding was. Staff knew the action to take if they had concerns about a patient’s safety and they told us they would feel confident to report concerns. Alerts were added to the patient record system when a patient was subject to a safeguarding concern so that all relevant members of the staff team could readily identify this. A review of the arrangements for keeping the safeguarding register up to date and subject to regular review was required.

Feedback from people who used the service did not include any concerns with regards to safeguarding.

Staff recruitment procedures were in place to ensure staff were appropriate to work in the service.

The service worked with people to understand and manage risks. The care and treatment provided was safe, supportive and encouraged people to remain healthy. Patients were advised on risks related to their condition and actions to take if their condition deteriorated. Staff were trained in areas to support people who lived with long term health conditions, for example, diabetes. Patients were called in for regular checks on their health when they were living with a long term condition.

The provider encouraged patients to attend for health screening. People who had not attended for cancer screening were followed up and encouraged to attend.

Our review of the patient clinical record system showed that patients who were prescribed high risk medicines were being monitored effectively overall.

The service was located in a purpose built building that provided the required facilities such as safe access for people with physical disabilities. The premises were clean and contained the appropriate facilities to support infection prevention and control.

The provider detected and controlled potential risks in the environment. They made sure equipment, facilities and technology supported the delivery of safe care. Regular checks were carried out on the premises, facilities and equipment provided. Contracts were in place to ensure the premises were clean and well maintained.

The provider ensured that health and safety related assessments and procedures to manage health and safety were in place. We noted that there had not been a recent fire drill. The provider scheduled a drill in response to our findings and additional staff were provided with fire warden training.

Staff had completed training in health and safety related topics such as fire safety, infection control and manual handling. Staff told us in discussions and feedback forms that they had no concerns with the arrangements in place for ensuring health and safety.

There was a business continuity plan in place to provide guidance for dealing with a major disruption to the service, for example an IT failure.

Patients experienced care and treatment from a stable clinical team. Feedback from people who used the service that was shared directly with CQC was overall positive with comments indicating high levels of satisfaction with members of the staff team.

The provider was in the process of recruiting to a small number of staff vacancies. Some staff told us staffing could be a challenge as a result of vacancies but they felt that overall, there were enough staff to provide safe, high quality care and they worked effectively as a team. There were appropriate arrangements in place for covering staff sickness, absence and vacancies and the use of temporary staff was minimal.

Staff received effective support, supervision and opportunities to develop. Staff were provided with the support they needed to deliver safe care. They told us they had protected learning time for them to undertake training, learning and professional development and that they had received training appropriate and relevant to their role. Annual appraisals had been scheduled for members of the non-clinical team but we noted that these were overdue.

We looked at the recruitment records for a sample of 3 members of the staff team. The recruitment practices for one of these had not been carried out fully in line with requirements. The provider took action to address this following the assessment and provided assurance of the improvements made to the recruitment process and including a process for ensuring the immunisation status of staff was obtained.

All new staff underwent an induction programme and were required to undertake mandatory training within an appropriate timescale.

The facilities and premises were appropriate to support cleaning and the spread of infection. Personal protective equipment was in good supply and located appropriately around the premises.

The provider assessed and managed the risk of infection. There were clear roles and responsibilities around infection prevention and control with a dedicated lead person. Staff had completed training in infection prevention and control and they told us they were aware of their roles and responsibilities in this. Cleaning schedules were in place and infection prevention control and cleaning audits were carried out on a regular basis. Cleaning equipment was stored securely and in line with best practice.

The provider had procedures in place to ensure that medicines and treatments were safe and met people’s needs, however there were areas which required improvement.

We reviewed clinical records for patients who had been prescribed medicines which required routine monitoring. Our review showed that medicines were managed safely overall and the approach to medicines reflected current and relevant best practice and professional guidance. Staff followed clear procedures to make sure people taking higher risk medicines underwent the required checks and monitoring.

Regular medicines reviews were carried out for people who used the service to ensure their medicines were appropriate to their needs and safe.

Staff had access to emergency medicines and equipment including oxygen and a defibrillator. These were regularly checked for stock availability and to ensure they were in date. A review of the security of storage of these medicines was required. Vaccines were stored appropriately, and regular checks were carried out to ensure safe storage and stock.

The provider had effective systems to manage and respond to safety alerts overall. However, our findings from the searches of the patient record system showed a safety alert for the prescribing of a medicine used as a diuretic had not been acted upon. The provider took immediate action to address this.

Prescribing data for a number of medicines particularly gabapentin, pregabalin and psychotropics showed that there was a higher number of prescriptions for these medicines than national average. Reasons for this were discussed with the provider who told us they had started to reduce the prescribing of higher risk medicines. They provided findings and data from work in this area for other high risk medicines and they planned to replicate this model.