Background to this inspection
Updated
17 July 2019
Strelley Health Centre provides primary medical services to approximately 4,600 patients in the Strelley area of Nottingham. The practice is located at 116 Strelley Road, Nottingham, Nottinghamshire, NG8 6LN.
The provider is registered for the provision of the following regulated activities from Strelley Health Centre; Diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures, treatment of disease, disorder or injury.
Strelley Health Centre is part of the Beechdale Medical Group which has a further three GP practices located within a close radius. Each practice holds a Primary Medical Service (PMS) contract with Nottingham City CCG and each has a separate patient list. Beechdale Medical Group is a partnership between a GP and an advanced nurse practitioner. Patients registered with any practice within the Beechdale Medical Group have access to appointments at all practices within the group.
Strelley Health Centre is situated in an area of high deprivation falling into the most deprived decile. Income deprivation affecting children and older people is above the local CCG average and the national average.
The clinical staff comprises of regular locum GPs (male and female), a clinical pharmacist, two practice nurses, a healthcare assistant. Some clinical sessions are provided by the GP partner. The clinical team is supported by a group business manager, a practice manager and a team of reception and administrative staff. A number of staff work across the group.
The practice is open between 8am and 6.30pm Monday to Friday. There is no extended opening provided from this location but patients can access extended hours and weekend appointments at other locations within the group and as part of GP plus.
When the practice is closed out-of-hours GP services are provided by Nottinghamshire Emergency Medical services (NEMS) which is accessed by telephoning NHS 111.
Updated
17 July 2019
We carried out an announced comprehensive inspection at Strelley Health Centre on 14 May and 20th May 2019 as part of our inspection programme. At this inspection we found concerns and completed an unannounced inspection on 5 June 2019.
We previously carried out a comprehensive inspection at Strelley Health Centre in March 2017. The overall rating was Requires Improvement. The report of that inspection can be found by selecting the ‘all reports’ link for Strelley Health Centre on our website at .
This inspection looked at the following key questions
Safe
Effective
Caring
Responsive
Well Led
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 inadequate overall.
We rated the practice as inadequate for providing safe services because:
- The practice did not have clear systems and processes to keep patients safe.
- Receptionists had not been given guidance on identifying deteriorating or acutely unwell patients. They were not aware of actions to take in respect of such patients.
- The practice did not learn and make improvements when things went wrong.
We rated the practice as inadequate for providing effective services because:
- There was limited monitoring of the outcomes of care and treatment.
- The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.
- Some performance data was significantly below local and national averages.
We rated the practice as inadequate for providing well-led services because:
- While the practice had made some improvements since our inspection on July 2018, it had not appropriately addressed some of the findings addressed at the inspection. At this inspection we also identified additional concerns that put patients at risk.
- Leaders could not show that they had the capacity and skills to deliver high quality, sustainable care.
- The practice culture did not effectively support high quality sustainable care.
- The overall governance arrangements were ineffective.
- The practice did not have clear and effective processes for managing risks, issues and performance.
- The practice did not always act on appropriate and accurate information.
- We saw little evidence of systems and processes for learning, continuous improvement and innovation.
We rated the practice as inadequate for providing responsive services because
- Patients could not always access services in a timely manner. Patients with urgent needs were not appropriately referred to services.
- The practice had not reviewed patient feedback or attempted to improve patient satisfaction.
These areas affected all population groups so we rated all population groups as inadequate.
We rated the practice as requires improvement for providing caring services because:
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice had not reviewed patient feedback to assess satisfaction with the practice.
- There had not been any evidence of improving identification of carers or supporting carers.
As a result of these concerns, we took immediate action to impose urgent conditions remove the location on the registration. This means that regulated activities can no longer be carried out at Strelley Health Centre.
I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.
Special measures will give people who use the service the reassurance that the care they get should improve.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care