Background to this inspection
Updated
24 August 2018
LL Medical Care Ltd is located in a health centre, which it shares with two other GP practices and community services such as chiropodists and physiotherapists. The practice is a part of Waltham Forest Clinical Commissioning Group (CCG).
There are approximately 6000 patients registered with the practice, 4% of which are over the age of 75, which is lower than the national average, the practice also has a lower number of patients with a long-term condition at 45% compared to the CCG average of 54%. Sixty percent of the practices population is made up of black and minority ethnic groups and the practice has a deprivation score of 34, which is higher (more deprived) than the CCG average of 30 and the national average of 24.
The practice has one male and two female GP partners and a long-term locum who carry out a combined total of 22 sessions per week and two practice nurses who carry out a total of seven sessions per week. The practice also has a male health care assistant, a practice manager and deputy practice manager and a compliment of reception/administration staff members.
The practice operates under a Personal Medical Services (PMS) contract (a locally agreed alternative to the standard GMS contract used when services are agreed locally with a practice which may include additional services beyond the standard contract).
The practice is open Monday to Friday from 8:30am to 6:30pm and extended evening opening hours are on a Monday and Tuesday until 8pm. Phone lines are answered from 8:30am and appointment times are as follows:
- Monday 9am to 1pm and 2pm to 7:30pm
- Tuesday 9am to 1pm and 2pm to 7:30pm
- Wednesday 9am to 1pm and 3:30pm to 6:30pm
- Thursday 9am to 1pm
- Friday 9am to 12:30pm and 2pm to 6:30pm
The locally agreed out of hours provider covers calls made to the practice whilst the practice is closed, the practice is also a part of the local HUB which provides weekday evening and weekend appointments to their patients.
LL Medical Care Ltd operates regulated activities from one location and is registered with the Care Quality Commission to provide maternity and midwifery services, family planning, surgical procedure, treatment of disease, disorder or injury and diagnostic and screening procedures.
Updated
24 August 2018
This practice is rated as Good overall. (Previous rating 07 2017 – Requires Improvement)
The key questions at this inspection are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at LL Medical Care Limited on 23 May 2017 as a part of our inspection programme. The overall rating for the practice was requires improvement as there were breaches in the proper and safe management of medicines, assessing the risk for electrical equipment used and recruitment processes. There were also concerns with infection control, identifying patient carers, staff training, patient satisfaction, patient clinical outcomes and business continuity arrangements. The full comprehensive report published in July 2017 can be found by selecting the ‘all reports’ link for LL Medical Care Ltd on our website at .
This inspection was an announced comprehensive inspection on 19 July 2018, carried out to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation identified in our previous inspection on 23 May 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.
Our key findings were as follows:
- 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 had an effective system for monitoring high risk medicines and positive test results.
- 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.
- Documentation in patients’ records were detailed and effective.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Adequate infection and prevention control procedures were in place.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- The practice proactively identified carers and over 1% of the practice list was coded as having caring responsibilities.
- Complaints were managed in an appropriate and timely manner, but the practice could not demonstrate that learning was shared in a timely way.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
The areas where the provider should make improvements are:
- Ensure learning and outcomes from complaints are shared with all relevant staff member in a timely way.
- Continue to work to improve patient satisfaction as identifies from the national GP patient survey.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.