The Ruddington 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 meant safety was a priority, and people were protected from abuse and avoidable harm.

This service scored 62 (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 were supported to raise concerns and staff treated them with compassion and understanding. A representative from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. For example, the service implemented an appointment system for weekend flu clinics following feedback from the PPG that open access had resulted in people waiting in long queues to be seen. Managers encouraged staff to raise concerns when things went wrong. Incidents were discussed and learning disseminated through staff meetings. Staff generally felt there was an open culture, and that safety was a top priority. 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.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 shared concerns quickly and appropriately. Safeguarding policies were in place and known to staff who were appropriately trained in safeguarding procedures. The service maintained a list of vulnerable people and acted on concerns by working in partnership with other organisations. Multidisciplinary team meetings were used to raise awareness of potentially vulnerable groups of people. There were systems in place to follow up people who failed to attend important appointments in primary and secondary care or, were frequent attenders to the emergency department.

The service worked with people to understand and manage risks. Care was provided to meet people’s needs. Systems were in place for checking and monitoring emergency equipment and medicines. We found that several recommended emergency medicines and suction equipment were not available and assessments to mitigate the risk had not been completed. The provider forwarded an action plan following our assessment which demonstrated the emergency medicines and suction equipment had been ordered. Staff could recognise a deteriorating person and knew the action to take. People were advised on risks related to their condition and the actions to take if their condition deteriorated.

The service detected and controlled the majority of potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The majority of risk assessments were in place where appropriate. An external fire risk assessment had been completed in 2017 and had not been updated following changes to the building. A less detailed internal fire risk assessment had been completed. Records showed the fire alarm was not being routinely tested on a weekly basis. Staff completed online fire training and attended regular fire drills. The most recent legionella risk assessment was not available at the time of the onsite visit, although action to test for legionella had been completed. The risk assessment detected legionella in the taps in the staff rooms. The certificate seen indicated that remedial work had been completed in January 2025 but did not confirm the system was free from legionella. The provider contacted the company during the onsite visit to request the risk assessment and evidence there was no legionella. Electrical equipment had been calibrated and tested.

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. Staff were positive about the support, training and development they received. The provider acknowledged where staffing was challenged, for example due to maternity leave, and action had been taken to address this. The service was building resilience in the staff team through training staff to be able to work in a range of roles. Safe recruitment processes were in place and staff received appropriate training. Feedback from some staff suggested the team may be benefit from an increase in health care assistant hours.

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. There were systems in place to assess and manage the risk of infection. ICP audits had been completed. There was a designated infection, prevention and control (IPC) lead who staff were aware of. Staff had received relevant training in IPC. Risk assessments and audits were completed, and action plans were in place to mitigate potential risks. Clinical waste procedures were in place. However, a complete record of staff immunisations, in line with national guidance , was not available in all of the staff files we reviewed. The provider forwarded information following our assessment which demonstrated complete records for 3 out of 5 staff. The provider forwarded to us an action plan to obtain this information.

Systems were in place to manage and respond to Medicines and Healthcare Products Regulatory Agency alerts however, for a small number of people, not all alerts had been fully adhered to. For example, risks associated with medicines used in the treatment of diabetes, chronic heart failure or chronic kidney disease. Some people over the age of 65 years old who were prescribed non-steroidal anti-inflammatory, anti-platelet or anti-coagulant medicines had not always been co-prescribed a medicine to prevent gastric complications. Most people prescribed medicines with specific risks received the recommended monitoring however, this was not always consistent. For example, there was follow up within 48 hours of a small number of people who received treatment following an exacerbation of their asthma. Immediately after our assessment the provider forwarded to us an action plan to address these 3 issues. Systems for managing the prescribing of medicines and treatment of other medicines were safe and met people’s needs. Protocols effectively supported the safe prescribing of medicines and staff involved people in reviews of their medicines. Medicines were prescribed appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. Systems were in place for checking the stock levels and expiry dates of all medicines, including emergency medicines and vaccines. Medical gases, such as oxygen, were stored securely. Prescription stationery was stored securely and tracked throughout the practice.