Archived: The London Road Medical Centre

We carried out an announced inspection The London Road Medical Centre on 10 December 2021. Overall, the practice is rated as Requires Improvement.

Safe - Requires Improvement

Effective - Requires Improvement

Caring - Good

Responsive - Good

Well-led - Requires Improvement

Following our previous inspection on 23 April 2019, the practice was rated Requires Improvement overall, all key questions were rated Requires Improvement except for the provision of effective, caring and responsive services, which were rated Good.

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

Why we carried out this inspection

This was a comprehensive follow up inspection which included a review breaches of regulation found at the previous inspection and areas of service that we advised should be improved.

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.
• 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 to the practice.

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 rated the practice as Requires Improvement for providing safe services because:

• Systems to assess, monitor and manage risks to patient safety were not always effective. For example, infection prevention and control and legionella risks.
• Staff did not always have the information they needed to deliver safe care and treatment.
• There were gaps in systems to ensure prescribed medicines were in line with current best practice guidance.
• There was insufficient clinical staff to meet the care and treatment needs of registered patients. This remained an ongoing issue for the practice.
• The system used to make improvements when things went wrong was not consistently applied.

We rated the practice as Requires Improvement for providing effective services because:

• Records showed that reviews of patients with long-term conditions were not always completed in line with current best practice guidance.
• Although the pandemic had had a detrimental effect on the practice’s ability to deliver some care as well as treatment, performance relating to child immunisations and cervical screening still required improvement.
• Not all staff had access to regular appraisals.

We rated the practice as Requires Improvement for providing well-led services because:

• Leaders could not always demonstrate that they had the capacity and skills to deliver high quality sustainable care.
• The practice did not always have a clear vision or credible strategy to provide high quality sustainable care.
• The overall governance arrangements were not effective.
• The practice did not always have clear and effective processes for managing risks, issues and performance.
• There was little evidence of systems and processes for learning, continuous improvement and innovation.

We rated the practice as Good for providing caring and responsive services because:

• 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.

The areas where the provider must make improvements 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 that sufficient numbers of suitably qualified, competent, skilled and experienced staff to meet the needs of the people using the service at all times.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.

The areas where the provider should make improvements are:

• Continue with and complete their action plan to ensure all health and safety risks are addressed appropriately.
• Continue with their plan to reduce the number of antibiotics prescribed.
• Continue to improve immunisation and screening uptake, specifically childhood immunisations and cervical cancer screening.
• Improve patients satisfaction in areas identified in the National GP patient Survey.
• Improve the management of complaints and to include verbal complaints made within this process/system.

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