Background to this inspection
Updated
5 July 2018
At the request of the local clinical commissioning group Lea Village Medical Centre was merged with Midlands Medical Partnership (MMP) in April 2017 to support improvements within the practice. MMP formally registered with CQC as the new provider organisation for the practice in July 2017.
MMP is a provider of scale consisting of a management board of five elected members, 19 partners and12 practices. Eleven of the practices are on a single General Medical Services (GMS) contract and have a combined patient list size of approximately 71,000 patients. Midlands Medical Partnership-Lea Village Medical Centre is currently on a separate GMS contract. MMP employs approximately 200 clinical and non-clinical staff across the whole organisation.
The MMP central management team are located at their head office in Eaton Wood Medical Centre, 1128 Tyburn Road, Erdington, Birmingham B24 0SY. The centralised management team provide managerial and administrative support for all their practices.
MMP has registered twolocations with CQC: Midlands Medical Partnership - Birmingham North East which covers 11 practice sites and Midlands Medical Partnership-Lea Village Medical Centre which includes this practice only.
Midlands Medical Partnership-Lea Village Medical Centre is registered with CQC to provide the following regulated activities: Diagnostic and screening procedures; Family planning; Maternity and midwifery services; Surgical procedures; Treatment of disease, disorder or injury. It has a registered list size of approximately 2300 patients (which has yet to be merged with the main MMP patient list). The practice is situated in the Kitts Green area of Birmingham serving a population that is within the 10% most deprived areas nationally.
Staffing at this Lea Village Medical Centre consists of a GP (MMP partner, male), a locum GP (female), a locum practice nurse and a health care assistant. There is also a team of administrative / reception staff which include a team leader, a senior administrator, two reception staff and a secretary. MMP provide specialist nursing cover for the diabetic and respiratory clinics and practice nurse cover when needed.
The practice is open between 9am and 6.30pm Monday, Tuesday, Wednesday and Friday. On a Thursday the practice is open between 9am and 1.30pm. When the practice is closed there are arrangements with another provider (Birmingham and District General Practitioner
Emergency Room group) to provide primary care services both within and out of hours.
The principal GP at Lea Village Medical Centre runs weekly dermatology clinics at the site for registered and non-registered patients with the practice.
Updated
5 July 2018
This practice is rated as inadequate overall.
The key questions are rated as:
- Are services safe? – Inadequate
- Are services effective? – Inadequate
- Are services caring? – Requires Improvement
- Are services responsive? – Requires Improvement
- Are services well-led? - Inadequate
We carried out an announced comprehensive inspection at Midlands Medical Partnership-Lea Village Medical Centre on 4 April 2018 and 19 April 2018. The practice last received a comprehensive inspection under the previous provider on 30 September 2016 and received an overall rating of requires improvement. Prior to this, the practice had been in a period of special measures.
The current provider of this practice registered with CQC in July 2017.
The reason for this inspection was to follow up the concerns identified at our previous inspections of this practice and other concerns that had been identified prior to the new provider registering this practice. The inspection was to ensure the legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were being met.
At this inspection we found:
- The new provider had put in place a range of systems and processes to support the practice in the provision of safe and effective services. However, these were not well embedded and were not followed by all staff at the practice.
- Risks were not always well managed within the practice and we found weaknesses relating to safeguarding arrangements, infection control, management of medicines, medical emergencies and for acting on incidents and safety alerts.
- We identified concerns in relation to the quality of care provided and found care and treatment that was not consistent with evidence based guidelines.
- Evidence seen suggested most staff involved and treated patients with compassion, kindness, dignity and respect.
- There was mixed feedback from patients with regard to the appointment system, a small proportion of patients reported that they found it difficult to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
- Although we saw significant changes had been made to restructure and improve the management of the practice, the governance arrangements that had been put in place had failed to identify and address some of the poor clinical care identified during the inspection and that the provider systems and policies had not been implemented by the local practice.
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure care and treatment is provided in a safe way to patients.
- Ensure patients are protected from abuse and improper treatment.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
The areas where the provider should make improvements are:
- Review the cause of delays in post being received and actioned to identify how this may be improved.
- Consider ways in which the identification of carers could be increased to ensure support is provided.
- Consider how the effectiveness and patient input into the practice could be improved.
- Review soundproofing of the main consulting room and how this may be improved.
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.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice