- GP practice
Mayflower Medical Centre
All Inspections
9 March 2022
During a routine inspection
We carried out an announced inspection at Mayflower Medical Centre on 09 March 2022. Overall, the practice is rated as good.
Set out the ratings for each key question
Safe - good
Effective - good
Caring - good
Responsive - good
Well-led - good
Following our previous inspection on 17 June 2015, the practice was rated Good overall and for all key questions.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Mayflower Medical Centre on our website at www.cqc.org.uk
Why we carried out this inspection.
This inspection was a comprehensive inspection to follow up on:
- Concerns received by the Care Quality Commission and the local clinical commissioning group about the ability of people to access the practice by telephone.
- The recommendations identified at the previous inspection.
How we carried out the inspection
Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.
This included:
- Conducting staff interviews using video conferencing.
- Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
- 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:
- Safeguarding, safety and risk management systems, infection control, and the dispensary and medicines management processes, were well managed.
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Care and treatment was appropriate, effective, and well monitored and patients received care and treatment that met their needs.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care. Patient feedback on inspection was positive, and GP survey results were in line with local and national results
- The practice had 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 and complaints were well managed.
- The practice was led and managed to promote the delivery of high-quality, person-centre care. There were effective governance, and risk management systems and processes.
Whilst we found no breaches of regulations, the provider should:
- Continue to improve the lower trending medicine indicators found on inspection.
- Continue to improve the uptake of childhood immunisations.
- Continue to improve the uptake of cervical cancer screening.
- Embed the updated monitoring process to ensure all clinical reviews had pathology results recorded.
- Continue to monitor and improve access to the practice via the telephone.
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
17 June 2015
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Mayflower Medical Centre on 17 June 2015. Overall the practice is rated as good.
Specifically, we found the practice to be good for providing safe, caring, well-led, effective and responsive services. It was also good for providing services for older people, people with long term conditions, families, children and young people, working aged people (including those recently retired and students), people whose circumstances make them vulnerable and people with mental health (including people with dementia).
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Improvements were needed in how safety alerts and significant events were acted on and monitored.
- Patients’ needs were assessed and care was planned and delivered following best practice guidance and referrals to secondary care services were made in a timely way.
- Patients said they were treated with empathy, compassion, dignity and respect. They said that they were listened to and involved in making decisions about their care and treatment.
- Information about services and how to complain was available and easy to understand. Improvements were needed in the way that complaints were responded to.
- Appointments were flexible to meet the needs of all population groups.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- There was a clear leadership structure and staff were supported by management. The practice sought feedback from staff and patients.
However there were areas of practice where the provider needs to make improvements.
Importantly the provider should:
- Review the systems dealing with and acting on safety alerts and significant events to improve patient safety.
- Ensure that staff who undertake chaperone duties complete training regarding these duties.
- Review policies and procedures around handling and storing vaccines and blank prescription pads.
- Ensure that all complaints are responded to in line with practice policies and procedures.
- Ensure that policies and procedures are reviewed so that they reflect accurately the day-to-day management of the practice.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice