Stratum Clinic

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 assessed all quality statements from this key question. There had been improvements in the operation of safety systems since the previous inspection. There was a positive learning culture and systems designed to keep patients safe. Systems for safeguarding, the management of risks, the environment, staffing levels, infection prevention and control and the management of medicines were effective. However, a minor improvement is required in relation to the storage of emergency medicines.

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.

Patients were positive about how informative clinicians were and were offered clear advice to help them to understand their health and treatment. Patients were satisfied with the complaints process and action taken by the provider.

Leaders had a proactive approach to patient safety. Staff had access to the incident reporting system and were encouraged to report all incidents for shared learning opportunities. There was a pro-active learning culture with patient safety as a priority.

The service had effective processes to record and action significant events. Learning was shared with relevant staff to reduce the risk of repeat issues. Patient complaints were handled effectively and learning shared. There was an effective system for acting on patient safety and medicine alerts.

Patient feedback collected by the service did not provide any comments regarding movement between different services. However, from online consumer reviews we found feedback that communication between GPs and the clinic was positive and the clinic provided updates to GPs on the patient’s diagnosis and treatment.

Staff and leaders told us they worked with external services by receiving and making referrals and told us patient care and support was discussed and organised at multi-disciplinary team meetings they attended with external services.

We did not receive any feedback from partners as part of this assessment. We spoke with commissioners of NHS services but they did not have any information regarding the service. There was no feedback from NHS providers regarding the service.

We looked at patient records and found the service worked effectively with external services in receiving referrals, making referrals and undertaking multi-disciplinary team meetings regarding patients’ care. Where patients had a potentially urgent clinical need, such as a suspected cancer, the service could fast-track them into an appointment for urgent clinical review.

Staff were aware of the service’s safeguarding lead and how to access them. All staff we spoke with were aware of their responsibilities in reporting concerns. There were effective systems, processes and practices to make sure people were protected from abuse and neglect.

The safeguarding policy was accurate and had all relevant safeguarding information and staff had received training to the appropriate level. Safeguarding systems helped keep patients safe.

The service collected feedback from their patients. The analysis reflected that the majority were positive about the services provided. The service replied to online feedback provided by patients. Action was taken to improve services where identified.

Staff were aware of potential red flag symptoms and understood their responsibilities to manage emergencies. Appropriately trained staff acted as chaperones.

The service had improved the quality of their medical records to record appropriate information prior to delivering care, such as medical history and allergies. Records were now being audited for compliance. The system to manage medical emergencies was effective. The service was equipped to respond to medical emergencies and staff had undertaken training in basic life support, health and safety and fire training. The service was able to offer additional support to patients who required information in an accessible way to ensure patients could understand and make informed decisions about their care and treatment.

Health and Safety risk assessments were carried out and appropriate actions were taken. Staff had completed relevant health and safety training, including fire safety.

Equipment was maintained, with up to date testing and calibration to ensure electrical appliances remained safe to use.

Appropriate risk assessments had been undertaken and where remedial action was required this was being actioned in a timely manner.

All staff had Disclosure and Barring Service (DBS) checks relevant to their roles and other checks to ensure they were fit and safe to provide care to patients.

Leaders told us all clinical and non-clinical staff had Disclosure and Barring Service (DBS) checks as all staff worked with patients, this included to act as chaperones to support patients during consultations. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

Doctors at the service had full vaccination records, health check disclosures and questionnaires to declare any health-related issues which may impact on their ability to provide care safely. During this assessment we found evidence that appropriate records and ongoing checks were being carried for clinical staff and all doctors had the required vaccination records in place.

From a review of patient feedback collected by the service since November 2023 and from an online consumer review website, we did not find any feedback which related to infection control.

Staff we spoke with were clear on their role and responsibilities relating to infection control and had completed relevant training. Some staff had also undertaken a hand hygiene audit in January 2024 and no actions were identified from this.

Staff were clear on their role and responsibilities relating to infection control and had completed relevant training. Some staff had also undertaken a hand hygiene audit in January 2024 and no actions were identified from this.

There were effective processes in place to assess and manage the risk of infection, including annual infection control audits. The service had undertaken an infection control audit which reflected effective processes were in place. The service had an up to date infection prevention and control policy which was available to all staff.

Staff helped people to understand their medicines and how to manage them safely. People knew who to contact if their condition did not improve or they experienced any unexpected symptoms.

Staff explained the systems and processes used to manage medicines. They were supported by policies and training.

While on site we found the emergency medicines and equipment held by the service were stored appropriately, however, some emergency medicines were stored in a locked cupboard and there was no sign to direct staff where to find these in an emergency. Staff who managed these medicines knew where each of them was stored, but other members of staff who may have needed to use them may not have known. We also found the log for medicine stock kept on site was not appropriately used to monitor all medicines, however, the service rectified this immediately. We reviewed the cold chain processes and found recording of temperatures were appropriately documented to ensure medicines were stored at the correct temperature.

At the last inspection, we found fridge temperature records were incorrectly recorded and therefore monitoring was not appropriate, and staff were not able to locate a cold chain policy or standard operating procedure in relation to the storage of refrigerated medicines. At this assessment, the service was able to demonstrate this had improved as they had implemented a cold chain policy as well as monthly cold chain audits to ensure staff were consistently monitoring fridge temperatures correctly. There were processes in place to ensure staff stocked, prescribed, administered or supplied medicines to patients and advice on medicines was provided in line with legal requirements and current national guidance. At the previous inspection, we found there was minimal prescribing audits to ensure medicines were provided to patients safely and in line with guidance. During this assessment we found some improvement had been made and we reviewed a recent prescribing audit from April 2024 which audited the prescribing to 9 patients between June and September 2023 to ensure medicines were prescribed safely to patients. This audit found an average compliance score of 97% and documented actions and learning to share with clinicians. The audit indicated a further audit would be carried out in July 2024.