Arran 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.

This is the first inspection for this service since its registration with CQC. This key question has been rated as Good.

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.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. Representatives from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical issues. Staff felt there was an open culture. 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. Learning from incidents and complaints resulted in changes that improved care for others.

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.

There were systems in place for processing information relating to new patients. 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.

Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. The practice maintained a list/register of vulnerable people and acted on concerns working in partnership with other organisations. The practice had a safeguarding lead and staff discussed vulnerable patients during practice meetings.

We found that registers had been updated, however, the practice did not have a system to ensure that each patient on the register was reviewed regularly and their records updated accordingly. The practice did not use a system to identify the level of risk for each person on the register. This would have allowed them to identify which patients required more frequent monitoring and those at highest risk of harm or abuse.

The provider sent us information, after the assessment, which showed they were taking action to review all patients on their registers.

Staff knew their patient population well and told us they worked with patients to understand and manage risks. While there was some evidence of patients being advised on risks related to their condition and actions to take if their condition deteriorated; from our record reviews, we found the provider could not demonstrate that they did this consistently.

Medicine reviews we looked at were poorly documented and we found that staff did not regularly review patient’s safeguarding needs so that people were informed about any risks and how to keep themselves safe.

Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and knew of action to take.

The provider used an external facilities management company to help detect and control potential risks in the care environment. We found that equipment had been tested as safe for use and contracts were in place to ensure the premises were maintained. There was a business continuity plan in place which was monitored and reviewed.

However, we found that while risk assessments relating to the building had either been reviewed or a date for repeat assessment arranged, they had not always been completed by their review date. For example, the fire risk assessment and Health and Safety risk assessment was overdue by 3 months and the electrical safety certificate had been completed 11 months after its due date.

Health and safety risk assessments and audits had been undertaken in February 2024 and risks identified had been addressed.

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.

During the assessment we identified that one clinical staff member required further training to support them in their role. When we spoke with the staff member and management, they told us this had already been identified and training was being arranged. We were sent information following the site visit that indicated that training had been arranged.

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

We did not identify any concerns with infection, prevention and control during our onsite inspection.

Patients knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. Staff felt confident managing the storage, administration 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 for all medicines, including emergency medicines and vaccines.

Staff mostly followed protocols to ensure they prescribed all medicines safely, and ensured patients received all recommended medicines reviews and monitoring.

The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff mostly followed established processes to ensure patients prescribed medicines with specific risks received recommended monitoring. However, we identified that not all patients who had been prescribed medicines to treat heart conditions had received the required monitoring. The provider took immediate action to call patients in for monitoring and/or review their prescribing.

Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this.

There was a programme of regular clinical audits of prescribing that focused on improving care and treatment. However, from evidence that we reviewed, the provider could not always demonstrate that outcomes had improved or that an action plan had been implemented.

We also found that medicine reviews were poorly documented and the provider could not demonstrate that staff always involved patients in reviews of their medicines.

We discussed our concerns with the management team, they told us there had been recent changes in staff that carried out roles related to medicines monitoring and these roles had been assigned to new staff. There were plans to implement standard templates to make documentation of medicine reviews more consistent. Following the inspection, the Integrated care board (ICB) confirmed that the practice were engaging well with the ICB’s medicines management team to improve medicines management processes. The provider also sent to evidence to show that patients who required monitoring had either received this or they had been contacted to make an appointment.