The Care Quality Commission
  • Doctor
  • GP practice

Doddington Medical Centre

Overall: Good read more about inspection ratings

11d Benwick Road, Doddington, March, Cambridgeshire, PE15 0TG

Provided and run by:
Doddington Medical Centre

All Inspections

27 November 2023

During an inspection looking at part of the service

We carried out a targeted assessment of Doddington Medical Centre on 27 November 2023 without a site visit. Overall, the practice is rated as good. We rated the key question of responsive as requires improvement.

Safe -good

Effective – good

Caring - good

Responsive – requires improvement

Well led – good

Following our previous inspection in November 2021, the practice was rated good overall and for all key questions. At this inspection, we rated the practice requires improvement for providing responsive services.

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

Why we carried out this inspection

We carried out this inspection as part of our GP responsive assessment

  • Responsive question inspected

How we carried out the inspection/review

This included:

  • Conducting staff interviews using video conferencing.
  • Requesting evidence from the provider.

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:

  • The practice had positive, or no change reported within the GP national patient survey data since last year’s survey results. However, the practice was still below local and national averages.
  • Same-day child access was tailored where possible to avoid missing time out of school.
  • Patients were given options to self-book appointments to make access to the practice more streamlined.
  • The provider recognised the rural location for patients and did not run set clinics to allow flexibility for appointments and allocate appointments more fluid.
  • The practice was staffed to ensure appointment capacity was managed in a structured manner daily.
  • Longer appointment times were made available for more complex patients to avoid multiple appointments.
  • The practice had 341 carers and 28 young carers and provided priority access to appointments and welfare checks when required.
  • The provider would involve all staff with complaints to gain feedback and opportunities to learn, including self-reflection.

Whilst we found no breaches of regulations, the provider should:

  • Continue to monitor and audit patient feedback to improve patient responses in the national GP patient survey.

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

18 November 2021

During an inspection looking at part of the service

We carried out a desk-based review of Doddington Medical Centre on 18 November 2021.

The practice is rated as good overall.

We previously carried out an announced comprehensive inspection at Doddington Medical Centre on 23 November 2020. We rated this service as Good overall and for providing effective, caring, responsive and well-led services. We rated the practice as requires improvement for providing safe services.

At a previous comprehensive inspection published 17 October 2019, the practice was rated as inadequate overall with a rating of inadequate for providing safe and well led services. The practice was rated as requires improvement for providing effective services and good for providing caring and responsive services.

The practice had previously been inspected in February 2016 and was rated as good.

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

This desk-based review was to follow up on the breach of regulation and areas where the provider ‘should’ improve which were identified at our previous inspection. We found the required improvements had been made and the practice is now rated as good for providing safe services.

In this review we found:

  • The practice had implemented systems and processes to ensure patients received a structured medicines review and that it was recorded consistently and accurately within the patient records.
  • The practice had implemented systems to ensure their clinical oversight of staff competency was accurately recorded.
  • The practice had continued to review their prescribing of antibacterial prescribing medicines and worked with the CCG to ensure their prescribing was appropriate.
  • The practice had, throughout the COVID-19 pandemic, continued to offer appointments for cervical cancer screening, additional staff were available, clinics and appointments had been increased.
  • The practice had implemented a system to ensure all patients were clinically reviewed before any personal care adjustment codes were used to exclude them from any quality and outcome framework indicators.

We did not find any breaches of regulations; however, the provider should:

  • Continue to monitor and encourage patients to attend appointments for cervical cancer screening.

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

23 November 2020

During a routine inspection

We carried out an announced comprehensive inspection at Doddington Medical Centre on 23 November 2020. We rated this service as Good overall. This inspection was carried out to review in detail the actions taken by the practice to improve the quality of care provided and to confirm that the practice was now meeting legal requirements.

At the previous comprehensive inspection published 17 October 2019, the practice was rated as inadequate overall with a rating of inadequate for providing safe and well led services. The practice was rated as requires improvement for providing effective services and good for providing caring and responsive services. As a result of the concerns identified, the practice was issued with a warning notice for breaches of Regulation 12 Safe care and treatment and Regulation 17 Good governance. A requirement notice was issued for breaches of Regulation 18 Staffing. The practice was placed into special measures.

The practice had previously been inspected in February 2016 and was rated as good.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information the practice sent to us prior to the inspection
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering how we carried out this inspection. We therefore undertook some of the inspection processes remotely and spent less time on site. We conducted staff interviews and review documents sent by the provider from 4 November 2020 and carried out a site visit on 23 November 2020.

At this inspection we found;

  • Significant improvements had been made to the clinical and management teams within the practice. Additional clinical and non-clinical staff such as site leads had been introduced to ensure staff were supported, concerns were escalated without delay and information flowed to and from staff appropriately.
  • The practice had installed and populated a new practice intranet. Staff told us this had significantly improved communication and information flow for staff across all sites. Staff were able to easily access policies, procedures and minutes of meetings for shared learning.
  • The management team had oversight of training, but staff were able to review their own training records.
  • The practice had worked with the CCG medicines teams to ensure the improvements identified at our last inspection were made and sustained.

At our previous inspection, the practice was rated as inadequate for providing safe services. At this inspection, the practice was rated as requires improvement for providing safe services because:

  • Significant improvements had been made since our last inspection. However, we identified that the practice systems and processes to ensure the practice was able to evidence that all patients received a structured medicine review in a timely manner was not wholly effective.

At our previous inspection, the practice was rated as requires improvement for providing effective services. At this inspection, the practice was rated as good overall for providing effective services and in all population groups except working age people (including those recently retired and students). We rated working age people (including those recently retired and students) as requires as improvement because;

  • The practice performance in relation to the percentage of women receiving cervical screening was below the CCG and national average. The practice shared the plans they had in place to improve the uptake but these had been hindered by the restrictions due to COVID-19.

At this inspection, the practice was rated as Good for providing caring services because:

  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.

At this inspection, the practice was rated as Good for providing responsive services because:

  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

At our previous inspection, the practice was rated as inadequate for providing well-led services. At this inspection, the practice was rated as Good for providing well-led services because:

  • The way the practice was led and managed promoted the delivery of high-quality, person-centred care.

The areas where the provider must make improvements are:

  • 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:

  • Continue to monitor and encourage patients to attend for cancer screening programme appointments.
  • Continue to monitor prescribing of antibiotics to ensure safe use of medicines
  • Continue to monitor and review exception reporting in relation to patients receiving reviews in a timely manner.

I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.

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

10 September 2019

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Doddington Medical centre on 10 September 2019 as part of our inspection programme.

We decided to undertake an inspection of this service on 10 September 2019 following our annual review of the information available to us. This inspection looked at the following key questions; are services safe, effective and well-led. During our annual regulatory review, we assessed that the ratings for caring and responsive services had stayed the same and are therefore rated as good.

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. The population group for patients with long term conditions is rated as inadequate. The other population groups are rated as requires improvement.

We found that:

  • The leadership within the practice had failed to ensure all legal requirements had been met.
  • The practice had encountered challenges since merging with other local practices and experiencing staff shortages. They told us they had been successful in recruiting more GPs and nurses.
  • The practice had not ensured care and treatment was provided in a safe way to patients.
  • Effective systems and processes to ensure good governance in accordance with the fundamental standards of care had not been fully established. This included infection prevention and control and risk assessments such as fire safety and legionella.
  • The practice had not provided staff employed the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
  • The recruitment systems and process within the practice failed to give clear oversight that all appropriate checks had been completed and monitored.
  • We found the systems and process within the dispensaries did not ensure safe management of medicines.
  • Feedback from patients we spoke with was positive about the care and treatment given by the staff at the practice. Feedback we had from comments cards was mixed with positive and negative comments about care and treatment that patients received.
  • The practice had implemented new technology to manage patient demand. An electronic triage system had been implemented, this had required a new telephone system to be installed. The practice had started to populate a new intranet system to improve the management and communication across the practice sites.
  • Immediately following our inspection, the Clinical Commissioning Group took urgent action to support the practice to make improvements. This included a review of the safety of medicines and vaccines.

We have rated the practice inadequate for providing safe services because;

  • The practice did not have clear systems, practices and processes to keep people safe.
  • The practice systems for the appropriate and safe management of medicines within the practice and the dispensary were inadequate.

We have rated the practice as requires improvement for providing effective services because;

The population group for patients with long term conditions is rated as inadequate. All other population groups are rated as requires improvement.

  • We found the practice had not reviewed and monitored all patients within a timely manner.
  • The practice shared with us the submitted but unverified QOF data which showed their performance for managing patients who maybe experiencing poor mental health had declined from 2017/2018.
  • We found the practice was in line with the 90% performance target for funding but was below the World Health Organisation (WHO) targets for childhood immunisation uptake rates.

Concerns we identified that affected all population groups were;

  • The practice did not demonstrate a programme of quality improvement such as clinical audits. We did not see clear evidence that quality monitoring was undertaken to improve outcomes for patients.
  • The practice was unable to clearly demonstrate that staff had the skills, knowledge and experience to carry out their roles.

We have rated the practice as inadequate for providing well led services because;

  • The practice leadership failed to have clear oversight of the management of the practice to evidence that they delivered safe and effective care and treatment.
  • We found the practice did not have systems and processes in place to ensure risk assessments including infection prevention and control were undertaken, issues identified, and actions completed. The systems and processes to ensure medicines, vaccines and equipment were managed safely and fit to use were inadequate. The management of recruitment and training did not ensure all staff had been appropriately checked and trained. The practice had failed to evidence that staff had been supported, received an appraisal and assessment of competency to ensure they could undertake their role and responsibilities.
  • The practice system and process to ensure patients had received appropriate review and ongoing management of their health in a timely manner was inadequate. This included patients with long term conditions and annual reviews for patients with a learning disability.

We noted the practice engaged with the CCG to review the immediate risks and developed an action plan to drive the improvements needed.

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.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure staff are suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment.

The areas where the provider should make improvements are:

  • Review and improve the system and process to review, action and monitor safety alerts to ensure clear oversight that action has been taken and record for future monitoring.
  • Review and improve the quality improvement systems such as clinical audit to encourage improvement.

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 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

9 February 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Doddington Medical Centre

on 9 February 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

  • Risks to patients were assessed and well managed.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

  • Information about services and how to complain was available and easy to understand.

  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.

  • The practice had good facilities and was well equipped to treat patients and meet their needs.

  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

  • The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

  • Ensure that clinical audit cycles are completed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

27 August 2014

During a routine inspection

Doddington Medical Centre provides a range of primary medical services to approximately 4400 patients living in Doddington, Wimblington, Stonea and Benwick.

We found that the practice provided a safe, effective, caring, responsive and well led service. The practice had proactively influenced commissioning decisions to help patients receive care closer to where they lived, rather than travelling to hospital or other health care settings.

All of the patients we spoke with during our inspection, and received feedback from, made extremely positive comments about Doddington Medical Centre and the service they provided. The staff told us that they felt supported.

In advance of our inspection we talked to the local clinical commissioning group (CCG) and the NHS local area team about the practice. The information they provided was used to inform the planning of the inspection.

We examined patient care across the following population groups: older people; those with long term medical conditions; mothers, babies, children and young people; working age people and those recently retired; people in vulnerable circumstances who may have poor access to primary care; and people experiencing poor mental health. We found that care was tailored appropriately to the individual circumstances and needs of patients in these groups.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.