Mamedica

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Medicines optimisation

We assessed three quality statements in the safe key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. The provider had appropriate systems to assess, monitor and continue to improve the quality and safety of service. There were processes for monitoring patients’ health in relation to the use of the medicines they prescribed which was, Cannabis based medicinal products (CBPMs). All patients had three monthly reviews with a consultant, pharmacist or clinical lead. Staff referred to, and communicated effectively with, other services when appropriate. Staff had a clear understanding of safeguarding with the appropriate training in place. People were involved with assessments and reviews about the level of support they needed to manage their medicines safely and to make sure their preferences were included.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

Feedback from users sought by CQC stated the service did not always provide a summary of care records when patients transferred to another clinic. The evidence we reviewed did not show any concerns about people’s experience regarding safe systems, pathways and transitions at this practice.

Staff referred to, and communicated effectively with, other services when appropriate. Staff told us that patients could not undertake a consultation to join the clinic until the provider had received their summary of care records from their NHS GP. Senior clinical staff described how care was delivered and reviewed. They told us that all patients had their initial appointment with a consultant and once they were assessed as stable they would be transferred through their shared care arrangements to internal clinical staff where they would be looked after by the patient care team and would speak with a clinical professional at least every three months. We saw evidence in patient files that showed that when patients transferred to other services their summary of care records were sent within 48 hours of the request coming in.

There were systems and processes to share information with staff and other agencies to enable them to deliver safe care and treatment. This included a shared care protocol and weekly multidisciplinary meetings.

Staff told us about how they would raise safeguarding concerns, we found they had a clear understanding of safeguarding with the appropriate training in place. Staff were aware of the providers safeguarding lead and there was literature around the clinic to signpost staff to where they could access support if the lead was not available. The managers told us about regular meetings that were held within the practice where safeguarding was discussed. The senior leadership team were able to demonstrate a clear understanding evidenced by policies and processes to ensure that necessary action was taken.

During our assessment we found that the provider had systems and processes in place to ensure patients were safeguarded from harm. They had appropriate policies and procedures in place and all staff had completed their safeguarding training to the appropriate level.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

Patients were involved in decisions about their treatments. We saw evidence in patient records of discussion between patients and their prescriber. The service had a process for supporting patients to receive alternative treatments when their prescribed product was out of stock. However, we saw from patient feedback that this was not always actioned in a timely manner.

Staff spoke highly of leaders and felt supported in their role by leaders and staff working closely together. Leaders spoke passionately about the service and shared examples of initiatives they were developing to help improve the service. This included the creation of a live stock document which would assist in reducing delays to patients treatment due to out of stock medications. Leaders were aware of their regional Controlled Drug Accountable Officer who would be able to support them with queries.

The service had a shared care process where non-specialist prescribers would prescribe ongoing prescriptions for patients once they were stable on their current dose. However, the service did not have clear patient specific parameters for non-specialist prescribers to adhere to when providing care under the supervision of the specialists. This was not in line with the service’s policy. Whilst we did not see any concerns in the records we reviewed, we did not see any examples of defined parameters in patients’ records. There was a risk that prescriptions could change significantly without the patient’s specialist being aware.