Background to this inspection
Updated
17 June 2019
Charter Medical Centre is located at 88 Davigdor Road, Hove, East Sussex, BN3 1RF. The practice has good transport links and there is a pharmacy nearby.
Charter Medical Centre is registered with the CQC to provide the regulated activities; Treatment of disease, disorder or injury; Surgical procedures; Diagnostic and screening procedures; Maternity and midwifery services and Family planning.
The practice is situated in the NHS Brighton and Hove Clinical Commissioning Group (CCG) and provides services to 24,050 patients under the terms of a general medical services (GMS) contract. The practice also provides care and treatment for the residents who are registered at the practice and who live in nearby care homes, which serve individuals with a diagnosis of dementia or who have nursing care needs. The practice runs a number of services for its patients including; sexual health advice and family planning, chronic disease management, smoking cessation, health checks and travel vaccines and advice.
There are eight GP partners and three salaried GPs (six male, five female). There are three advanced nurse practitioners, eight practice nurses, three health care assistants, one phlebotomist, a clinical pharmacist and a pharmacist technician. GPs and nurses are supported by the practice manager, the management team and a team of reception/administration staff.
Data available to the Care Quality Commission (CQC) shows the number of patients from birth to 18 years old served by the practice is comparable to the national average. The number of patients aged 85 years and over is comparable to the national average. The National General Practice Profile states that 89% of the practice population is from a white background with a further 11% of the population originating from black, Asian, mixed or other non-white ethnic groups. Information published by Public Health England rates the level of deprivation within the practice population group as six, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is comparable to the national average of 79 years. Female life expectancy is comparable to the national average of 83 years.
Charter Medical Centre is open from Monday to Friday between 8am and 6:30pm. Extended opening hours were between 6:30pm and 8pm on Tuesday and Thursday.
The practice is also part of a shared Extended Hours Service with another practice. The location of this service rotates every three months between Charter Medical Centre and another local practice. Appointments are offered every week night from 6.30pm to 8.30pm, Saturday from 8am to 2pm and once per month on a Sunday between 10am to 1pm.
Appointments can be booked over the telephone either with reception or using an automated service, online or in person at the surgery. Patients are provided information on how to access an out of hour’s service by calling the surgery or viewing the practice website ()
Updated
17 June 2019
We carried out an announced focused inspection at Charter Medical Centre 8 May 2019 as part of our inspection programme.
At the last inspection in June 2018 we rated the practice as requires improvement for providing safe services because:
- Patient Group Directions, adopted by the practice to allow nurses to administer medicines in line with legislation, were not always completed correctly.
- Safety alerts were not always documented, discussed and lessons learnt.
- The practice did not have reliable policies and protocols to make sure refrigerated medicines were stored safely.
We also found areas where the provider should make improvements:
- Strengthen the guidance provided for reception staff to include identification of symptoms for potentially seriously ill patients, such as sepsis.
- Strengthen the processes to record and monitor the risks to vulnerable patients registered at the practice.
- Review and improve the storage of completed staff induction checklists.
- Continue to monitor and take action where appropriate for low performance on QOF, including diabetes indicators.
- Strengthen the programme of clinical quality improvement activity, including to routinely review the effectiveness and appropriateness of the care provided.
We based our judgement of the quality of care at this service is 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.
Overall the practice continues to be rated as good and is now rated good for providing safe services.
Details of our findings
At this inspection we found:
- The practice had systems to make sure staff had appropriate authorisation to administer medicines. All patient group directions had been completed correctly and in line with legislation.
- There were processes to identify, understand, monitor and address current and future risks including risks to patient safety. The practice fully recorded, investigated and acted on safety alerts. Actions were taken to improve safety and lessons were learned.
- The practice had reviewed and updated their policies and procedures to ensure that refrigerated medicines would be appropriately monitored.
- The practice had resolved concerns relating to the guidance available to staff and they had provided additional training for identifying symptoms of serious infections.
- The practice had processes in place to make sure vulnerable patients were monitored, and appropriate actions were completed as a result of any concerns.
- The storage of staff files had been reviewed and there were checklists in place to ensure documentation was retained.
- Performance information relating to diabetes indicators was monitored and acted upon. The practice had updated their patient review template, provided staff with additional training and reviewed their recall process.
- The practice demonstrated they were involved in quality improvement activity. Information about care and treatment was used to make improvements.
The areas where the provider should make improvements are:
- Continue to embed new processes to ensure refrigerated medicines are appropriately stored and monitored, and any breaches of the cold chain are acted upon and fully recorded.
- Continue to monitor and take action where appropriate for low performance on QOF, including diabetes indicators.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.