Fir Tree Medical Centre

We carried out an announced inspection at Fir Tree Medical Centre on 14 March 2022. Overall, the practice is rated as requires improvement.

Safe - Requires improvement

Effective – Requires Improvement

Caring - Good

Responsive - Good

Well-led - Inadequate

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Fir Tree Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a comprehensive inspection covering all key questions.

We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Liverpool. To understand the experience of GP Providers and people who use GP services, we asked a range of questions in relation to urgent and emergency care. The responses we received have been used to inform and support system wide feedback.

How we carried out the inspection

This inspection was conducted at the practice location and included the following:

• Conducting staff interviews
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Reviewing evidence from the provider

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Requires Improvement overall

Safe is rated as Requires Improvement because:

• Not all staff were trained to the required level for safeguarding for their role.
• There was limited evidence of learning and dissemination of information.
• Not all required risk assessments had been completed.
• Systems and processes for monitoring patients care and treatment were not consistently applied.

Effective is rated Requires Improvement because:

• Patients’ care and treatment was not always regularly reviewed and updated.
• Systems to monitor quality of the service were not embedded or always effective.
• Staff induction was not tailored to their role.
• We did not see a formal system for managing staffing levels.

Caring is rated Good because:

• Patients were treated with respect and staff were kind, caring and involved them in decisions about their care.

Responsive is rated Good because:

• Services were tailored to meet the needs of individual patients and were accessible.

Well-led is rated Inadequate because:

• Some members of the leadership team had been recently appointed and their roles and responsibilities had not been clearly set out and were still being developed.
• Practice staff were not always aware of the roles and responsibilities of members of the leadership team and the lines of accountability within the organisation.
• The provider’s centralised governance function did not have clear systems and processes in place to support staff at practice level.
• The provider did not have a documented overall strategy underpinned by detailed, realistic objectives and plans for high-quality and sustainable delivery.
• The systems for identifying, managing and mitigating some risks were ineffective.
• There was no leadership development programme in place.
• The vision, values and strategy were not developed in collaboration with staff, patients and partners.

We found the following breaches of regulations. The provider must:

• Ensure the care and treatment is provided in a safe way to patients.
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The provider should:

• Review the system for checks of emergency medicines and equipment.
• Review the system for the security of prescription forms.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services