The Care Quality Commission
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  • GP practice

Archived: Frances Street Medical Centre

Overall: Good read more about inspection ratings

The Medical Centre, 2 Frances Street, Doncaster, South Yorkshire, DN1 1JS (01302) 349431

Provided and run by:
Frances Street Medical Centre

Important: The provider of this service changed. See new profile

All Inspections

8 and 9 November 2022

During a routine inspection

We carried out an announced inspection at Frances Medical Centre (or the Medical Centre as it is known locally) on 8 and 9 November 2022 Overall, the practice is rated as Good.

Safe - Good

Effective – Requires Improvement

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 6 April 2016 the practice was rated Outstanding overall and for responsive and well- led services and good for safe, effective and caring services.

At the last inspection, we rated the practice as outstanding for providing responsive and well-led services because:

  • The practice referred to the nurse who reviewed patients in their own home as the 'iNurse using video chat technology to perform joint consultations with the GP.
  • The practice had liaised with the local bail hostel whereby residents were supported to access health care at the practice within a safe environment.
  • The practice employed a clinical pharmacist who supported staff at the practice through review of medicines prescribed, promoting best practice and providing advice for prescribing.
  • The patient participation group liaised with staff to schedule a regular a programme of patient engagement events where practice staff and external speakers facilitated educational events for patients and people from the local community.

At this inspection, we found that those areas previously regarded as outstanding practice were now embedded throughout the majority of GP practices. While the provider had maintained this good practice, the threshold to achieve an outstanding rating had not been reached. We also found, areas of concern in effective following a clinical review of some patient records. There was a lack of consistency in the effectiveness of the care, treatment and support people with long term conditions received.

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

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • Reviewing staff feedback forms.
  • Reviewing PPG feedback forms.
  • Speaking with patients.
  • A short site visit.

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 have rated this practice as Good overall

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • There was a lack of consistency in the effectiveness of the care, treatment and support people with long term conditions received.
  • The service had a high turnover of transient patients which effected their national prevention and survey data outcomes. However, despite data being lower than national averages in some areas, the provider had implemented systems and had adapted services to meet the needs of its population groups.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.

The practice had gone to significant efforts to respond to the needs of some of the most vulnerable individuals in the city to support them to access health and social care.

  • The continuing development of the staff’s skills and knowledge was recognised as being integral to ensuring high quality care.

We saw some ares of outstanding practice, for example:

  • The practice was proactive in providing care and treatment to hard to reach and vulnerable patients such as asylum seekers, homeless people, people whose first language was not English and residents of bail hostels.

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

  • Continue with plan to minute safeguarding meetings for future reference.
  • Implement plan for monitoring of medication reviews.
  • Check ReSPECT forms are scanned on to the patients record.
  • Review historic safety alerts and take steps to ensure all necessary actions are taken.
  • Implement and embed systems for monitoring the effectiveness of the care, treatment and support people with long term conditions receive.
  • Continue with the plan to document non-prescribers’ supervisions.
  • Continue to improve uptake of national screening programmes.
  • Advise complainants of their right to escalate their concerns to the Parliamentary and Health Service Ombudsman.

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 Hospitals and Interim Chief Inspector of Primary Medical Services

6 April 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Frances Street Medical Centre on 6 April 2016. Overall the practice is rated as outstanding.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
  • The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice had liaised with the local bail hostel whereby residents were supported to access health care at the practice within a safe environment.
  • Feedback from patients about their care was consistently positive.
  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, t he practice employed a pharmacist who reviewed patients' medications, provided advice and support to patients and staff and also promoted medicines optimisation.
  • The practice had identified the current premises were adequate and recognised they had used all of the available space. They were reviewing their existing accommodation and planning for future requirements. It was equipped to treat patients and meet their needs.  
  • The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
  • The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
  • The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw several areas of outstanding practice including:

  • The practice referred to the nurse who reviewed patient's in their own home as the  'iNurse'. They visited those patients unable to get to the surgery at home and performed joint consultations with GPs at the practice using video chat technology. This enabled the patient to see the GP and the GP to see the patient. We were told how this was particularly useful reviewing patient's with conditions that required visual assessment. For example, those with skin rashes.
  • The practice had liaised with the local bail hostel whereby residents were supported to access health care at the practice within a safe environment.
  • The practice employed a clinical pharmacist who supported staff at the practice through review of medicines prescribed, promoting best practice and providing advice for prescribing.  Patients were also able to book appointments with the clinical pharmacist for advice and support how to take their medicines and all patients taking multiple medicines were regularly reviewed and on the day following discharge from hospital.
  • The patient participation group liaised with staff to schedule regular a programme of patient engagement events where practice staff and external speakers facilitated educational events for patients and people from the local community. Each year the PPG would meet and arrange the programme of events for the forthcoming year. Topics included living with alzhiemer's, an introduction to yoga, living with diabetes, bowel cancer screening, dementia primary care liaison nurse, overview of the wellbeing centre, services for patients who fall and minor illness advice from the local chemist. Patients told us they enjoyed the sessions and found them very informative and people travelled from other areas to attend.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice