The Care Quality Commission
  • Doctor
  • GP practice

Lion Health

Overall: Requires improvement read more about inspection ratings

2 Lowndes Road, Stourbridge, West Midlands, DY8 3SS (01384) 322249

Provided and run by:
Lion Health

Important: This service was previously registered at a different address - see old profile

All Inspections

21 November 2023

During an inspection looking at part of the service

We carried out an announced focused inspection at Lion Health on 21 November 2023. Overall, the practice is rated as Requires Improvement.

Safe – Good

Effective - Good

Caring - Good (this rating was carried from 2018 inspection)

Responsive - Inadequate

Well-led – Requires Improvement

Following our previous inspection in July 2018 the practice was rated outstanding overall.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Lion Health, on our website at www.cqc.org.uk

Why we carried out this inspection.

We carried out this inspection in line with our inspection priorities.

How we carried out the inspection/review

This inspection was carried out in a way that enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A short site visit.

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 found that:

  • Staff had the information they needed to deliver safe care and treatment.
  • The practice learnt and made improvements when things went wrong.
  • Staff worked together and with other organisations to deliver effective care and treatment.
  • Staff were consistent and proactive in helping patients to live healthier lives.

However:

  • Patients could not access care and treatment in a timely way.
  • Health and safety risk assessments were completed but action points had not always been scheduled or completed.
  • Infection prevention and control audit actions were not always actioned within a specific time frame.
  • The prescribing competence of non-medical prescribers had not always been audited or reviewed.
  • Medicines reviews did not always have completed and contemporaneous notes.
  • Safety alert actions had not always been taken within the appropriate timescale or shared effectively with the team.
  • Patients with long term conditions did not always receive medicine reviews and health checks in an appropriate timescale.
  • The practice uptake rate for cervical screening for eligible patients was slightly under the national requirement.
  • DNACPR form copies were not kept in the patient record and there was no policy or risk assessment applied to this decision.

We found one breach of regulation. The provider must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The provider should:

  • The practice should take action to ensure medicine reviews are completed and contemporaneous review notes are maintained.
  • The practice should take steps to increase the uptake rate of cervical screening for eligible patients.
  • The practice should ensure that DNACPR form copies not being held on site has been risk assessed.
  • The practice should ensure that a freedom to speak up guardian is in place.

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 Health Care

02 July 2018

During a routine inspection

This practice is rated as outstanding overall. (Previous rating March 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Outstanding

We carried out an announced comprehensive inspection at Lion Health on 2 July 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access same day care when they needed it. However, patient feedback on telephone access was generally negative.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw areas of outstanding practice:

• The practice had a dedicated advanced nurse practitioner (ANP) for patients in care homes and acutely unwell patients.

• The practice had adopted an ‘assertive outreach’ strategy to improve the uptake of long-term condition clinics. This involved proactively reaching out to patients based on clinical need; for example, online monitoring for working age people.

• When patients were assessed to be at risk of suicide or self-harm the practice had arrangements in place to help them to remain safe. The practice took a proactive approach to reduce suicide cases by holding an educational event with an external speaker and had internally reviewed cases to identify any learning.

• There was an extensive programme of governance meetings that included all staff and extended to a wide range of healthcare professionals. The programme of multidisciplinary team meetings (MDT) included dedicated time set aside from the main MDT meeting to discuss and review the care and treatment for palliative patients, patients with poor mental health and patients with respiratory conditions. As an example of good practice, the local CCG shared learning from this practice model with other practices within the CCG and had been used as a demonstrator site for other CCGs.

• The practice had developed their approach for managing patients with long-term conditions with the introduction of a dedicated administrative team and a patient centred approach to improving attendances for reviews. The non-attendance rate and the average attendance rate had both halved since 2016 and 80% of patients with a long-term condition had all components reviewed at one appointment. The percentage of patients on each long-term register who had received at least annual reviews was consistently high. The practice had written their own protocols for long-term condition management that provided comprehensive and effective treatment and care.

The areas where the provider should make improvements are:

• Ensure that the new telephone system improves access for patients.

Professor Steve Field CBE FRCP FFPH FRCGP

14 January 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

Lion Health has a practice population of approximately 24700 patients within the Dudley area.

We carried out a comprehensive inspection on 14 January 2015.

We have rated each section of our findings for each key area. The practice provided a safe, effective, caring, responsive and well led service for the population it served. The overall rating was good and this was because the practice staff consistently provided good standards of care for patients.

Our key findings were as follows:

  • Practice staff worked together as a team to ensure patients received the standards of care they needed.
  • There were safe systems in place for ensuring patients received appropriate treatments and prescribed medicines were regularly reviewed to check they were still needed.
  • Patients were protected against the unnecessary risks of infections because staff adhered to appropriate hygiene practices and regular checks were carried out.
  • The practice was able to demonstrate a good track record for safety. Effective systems were in place for reporting safety incidents. Untoward incidents were investigated and where possible improvements made to prevent similar occurrences.
  • Patients were treated with respect and their privacy was maintained. Patients informed us they were very satisfied with the care they received. The feedback we received from patients was without exception positive.

We saw several areas of outstanding practice including:

  • The main role of an advanced nurse practitioner is the provision of care for older people including those aged 75+ years. Home visits are also carried out to ensure care for older people meets their needs.
  • The main role of a mental health advanced nurse practitioner is the provision of care for patients with mental health illnesses. Home visits are also carried out. This service helps in provision of effective care and preventing escalation of patient’s mental health conditions.
  • Practice staff have introduced a system for patients with hypertension where they email their blood pressure recordings to the practice. Recording equipment is supplied by the practice. Staff responds accordingly by email and provide advice so that patients receive appropriate and timely care.
  • For patients above a specific weight clinical staff offer them a nutrition and exercise course to promote healthy lifestyles. The practice website gave guidance about various ways of healthy living including diet, exercises and promotion of women’s health.
  • Clinical staff visited two local schools and provided pupils with advice about sexual health and contraception.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice