Background to this inspection
Updated
12 March 2019
Littlebury Medical Centre is a rural, dispensing practice based in a purpose-built surgery located in the centre of Holbeach, Lincolnshire.
It has a current list size of 6, 816 patients and offers a full range of primary medical services and provides dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy premises.
The practice has a General Medical Services Contract (GMS). The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.
At Littlebury Medical Centre the service is provided by two GP partners (Male), one locum GP (Male), one practice manager, one assistant practice manager, two nurses, one paramedic practitioner, two health care assistants, five dispensers, three administration and seven reception staff.
On 6 February 2019 we inspected the following location where regulated activities are provided: -Littlebury Medical Centre, Fishpond Lane, Holbeach, Spalding, Lincs. PE12 7DE
The level of deprivation is sixth on the most deprived scale. The level of deprivation is 21% compared to a CCG average of 16% and national average of 24%. The level of income deprivation affecting children and older people is above CCG average but lower than national average.
The practice has 32.2% of patients registered at the practice aged 0yrs to 18, 25.2% aged 18yrs to 64, 26.3% aged 65 and over, 12.6% aged 75 and over and 3.7% aged over 85 years of age. Of these 98% are white British. (Source: Public Health England & 2011 Census)
Littlebury Medical Centre had opted out of providing out-of-hours services (OOH) to their own patients. The OOH service is provided by Lincolnshire Community Health Services NHS Trust. There are arrangements in place for services to be provided when the practice is closed and these are displayed on their practice website.
Updated
12 March 2019
Littlebury Medical Centre had been inspected previously on the following dates: -
- 5 April 2018 under the comprehensive inspection programmed. The practice was rated as Requires Improvement overall. Breaches of legal requirements were found in relation to safe care and treatment, safeguarding service users from abuse and improper treatment and governance arrangements within the practice. Requirement notices were issues which required them to submit an action plan on how they were going to take action to meet these requirements.
We carried out an announced comprehensive inspection at Littlebury Medical Centre on 6 February 2019 as part of our inspection programme.
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.
- Patients received effective care and treatment that met their needs.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
- The practice did not always have clear and effective processes for managing risk.
- The practice did not always act on appropriate and accurate information.
Whilst we found no breaches of regulations, the provider should:
- Review and embed the current systems for the recording of near misses in the dispensary, management of legionella, fire safety and emergency equipment and medicines.
- Continue the plan to drive improvement through clinical audit and the monitoring of national patient survey data to improve the experience of patients.
- Put a plan in place to ensure the nursing team have regular meetings which are documented.
- Improve the identification of carers to enable this group of patients to access the care and support they need and ensure information is available in line with NHS England Accessible Information Standard.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice