Fulwood Green 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. We assessed all quality statements 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 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Safe processes were in place for monitoring and reviewing care and treatment in a positive learning culture. These included managing incidents and significant events. Staff were encouraged to raise concerns and report incidents which were later discussed at clinical staff meetings. There was a log of all significant events and incidents. The provider had a complaints policy and procedures, and these were in line with recognised guidance. The service learned lessons from individual concerns and complaints and from analysis of trends. The service had processes and systems to ensure compliance with the requirements of the duty of candour.

The provider worked with a range of healthcare services to establish and maintain safe, effective systems of care for patients. Regular multi-disciplinary team (MDT) meetings were held to review the care of patients with complex conditions or those nearing the end of their lives, ensuring holistic, well-coordinated care. Clinicians followed established care pathways for diagnosis, treatment, and referral to specialist services. The provider managed referrals to secondary care, including urgent referrals for suspected cancer, and followed up appropriately. Communications from secondary care, such as discharge summaries, were processed efficiently to ensure continuity of care. There was a system for processing information relating to new patients, including the summarising of new patient notes. There were protocols in place for managing incoming correspondence into the patient’s medical records. The clinical team reviewed all patient correspondence, and our review of patient records showed that all tasks had been acted upon. Feedback from people who used the service indicated they felt involved in decisions about treatment pathways and they reported prompt follow up care.

The provider had implemented systems, processes and procedures relating to safeguarding, they ensured policies and procedures were reviewed and up to date and aligned with other local safeguarding teams. Staff we spoke with were aware of how to identify, report and take action for safeguarding concerns. Safeguarding alerts were added to the clinical record system when relevant, ensuring that all team members were aware of ongoing concerns and could act accordingly. The service had a designated lead for safeguarding adults at risk and children and staff were aware of this. The service had a register for vulnerable adults and children, and this was reviewed with the central safeguarding team monthly. Minutes of meetings showed at risk patients on the register had been reviewed. Partners and staff were trained to appropriate levels for their role. The service had a chaperone policy in place to maintain patient privacy during intimate examinations. Posters were displayed in all consultation rooms and waiting areas.

The provider worked with people to understand and manage risks through a holistic approach. The service encouraged patients to attend for health screening. Parents of children who had not attended for childhood immunisations and people who had not attended for cancer screening, were followed up and further encouraged to attend.Patients who were prescribed high risk medicines were called for regular checks. Staff, including locum staff and GP trainees, were provided with an extensive range of tools and guidance to aid them to support people living with long-term health conditions such as diabetes, hypertension, and lung disease. An effective system was in place to respond to patient safety alerts and patients were given advice on the risks related to their conditions with clear guidance on what actions to take if their health deteriorated.

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 provider had health and safety and fire risk assessments systems in place to evaluate, address, and monitor any safety concerns related to the premises. The provider had systems in place to test all equipment to ensure it was safe to use. records were shown indicating all the checks were completed annually. There was a business continuity plan in place which was monitored and reviewed.

The provider ensured there were enough qualified, skilled and experienced staff, who received support, supervision and development opportunities. Staff worked well together to provide safe care that met people’s individual needs. The provider had safe recruitment practices to make sure that all staff, including agency staff, were suitably experienced, competent and able to carry out their role. Processes were in place to ensure staff were fit to work at the service, for example when undertaking Disclosure and Barring Service (DBS) checks. Some non-clinical staff did not have a DBS check and there was no risk assessment in place to support this decision. Following the assessment the provider acted for our concerns and forwarded a risk assessment to support their decisions. We found on the day of the assessment there was no records of staff fitness and recruitment for clinical registrars within at the service. We discussed this and the information was forwarded to CQC following the assessment. Systems were in place to ensure staff received good support, supervision and appraisals for their professional development. Staff confirmed they received training appropriate and relevant to their role. They told us they felt supported with their personal development and were given opportunity to learn. Staff confirmed that meetings took place with non-medical prescribers to review their prescribing practice, however these were informal and there were no records made of the meeting.

The provider carried out infection prevention and control audits and where needed took actions. The last service audit was carried out in September 2023 and the results showed 85% compliance, there was evidence that this was reviewed in December 2024. The provider protected people as much as possible from the risk of infection because the premises and equipment, and waste arrangements were appropriate. Some nurses had responsibilities around infection prevention and control, and they linked in with other infection control leads in the area.Staff vaccination was maintained in line with current UK Health and Security Agency (UKHSA) guidance, if relevant to their role. There was a system for the service to report infection-related concerns to the relevant agencies (e.g. notifiable diseases).

The provider had systems in place for medicine optimisation to meet people’s needs, capacities and preferences. Medicines including vaccines were stored safely and staff were aware of what to do if a fridge temperature was out of range. Staff had access to emergency medicines and equipment including oxygen and a defibrillator. The provider ensured that nurses were appropriately authorised to administer some medicines in line with Patient Group Directions (PGDs) (written instructions to supply or administer medicines to patients in planned circumstances for example, vaccinations). Reviews of non-medical prescribing practice had taken place informally. The provider made sure that medicines and treatments were safe and met people’s needs. We reviewed clinical records for patients who had been prescribed medicines which required routine monitoring. Our review showed that medicines were managed safely and the approach to medicines reflected current and relevant best practice and professional guidance. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. Our review of the patient clinical record system showed that patients who were prescribed high risk medicines were being monitored effectively. We noted that a small number of patients were overdue checks relating to their medicines. The provider told us how they had addressed this immediately following our assessment.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. We found they had taken appropriate action in response to the medicines alert we looked at.