The Care Quality Commission
  • Doctor
  • GP practice

Brook Medical Centre

Overall: Good read more about inspection ratings

Ecton Brook Road, Northampton, NN3 5EN (01604) 401185

Provided and run by:
Brook Medical Partnership Limited

All Inspections

16 November 2022

During a routine inspection

We carried out an announced comprehensive inspection at Brook Medical Centre on 15 November 2022, this included remote interviews on the 14 November, and a site visit on 16 November 2022. Overall, the practice is rated as Good.

Safe - Good.

Effective – Good.

Caring – Good.

Responsive – Good.

Well-led – Good.

The practice received an overall rating of requires improvement at our inspection on 10 September 2021. A warning notice was issued to the provider in relation Regulation 17 Good governance. We undertook an interim inspection on 15 March 2022 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation set out in warning notice we issued. During this inspection, further breaches of Regulation 17 Good governance were identified and the warning notice was updated and reissued.

This inspection was undertaken to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation set out in warning notice we issued to the provider in relation to Regulation 17 Good governance.

The full comprehensive report from the September 2021 inspection can be found by selecting the ‘all reports’ link for Brook Medical Centre on our website at www.cqc.org.uk.

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.

Our key findings were as follows:

We found that:

  • Evidence provided demonstrated the new management team had adopted a systematic approach to improvement. Previous concerns had been addressed and there was a comprehensive set of action plans in place to support continued improvements.
  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • There was evidence to demonstrate newly implemented clinical governance systems were operating effectively to reduce risks to patient safety and those associated with medicines management.
  • Policies and procedures had been established to enable the practice to operate safely and effectively. Systems for ensuring management oversight of staff had been improved.
  • 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.
  • 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.

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

  • Continue to encourage and engage patients to attend for cervical screening.
  • Continue to encourage parent and guardians to vaccinate their children.
  • Continue to monitor action plans formulated to reduce risks to staff and patient safety. Including the recruitment of additional support to facilitate note summarising of new patient records.
  • Continue with efforts to formulate an active Patient Participation Group (PPG).

Details of our findings and the evidence supporting our judgements 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

15 March 2022

During an inspection looking at part of the service

We carried out an announced focused inspection of Brook Medical Centre on 15 March 2022. This inspection was undertaken to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation set out in a warning notice we issued to the provider in relation to Regulation 17 Good governance.

The practice received an overall rating of requires improvement at our inspection on 10 September 2021. This will remain unchanged until we undertake a further comprehensive inspection within 12 months of the publication of the previous report on 1 November 2021.

The full comprehensive report from the September 2021 inspection can be found by selecting the ‘all reports’ link for Brook Medical Centre on our website at www.cqc.org.uk.

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.

Our key findings were as follows:

We found that:

  • The practice had not fully complied with the warning notice we issued but had taken some action needed to comply with the legal requirements. Medicine safety alerts were not consistently acted upon which put patients at risk.
  • The practice had not responded to concerns identified in relation to staff vaccination status for specific infections.
  • There were still gaps in mandatory staff training in safeguarding and infection prevention and control.
  • Emergency medicines were stocked and those not held had been risk assessed.
  • Systems for ensuring management oversight of staff had been improved. All but one member of staff had received an appraisal since our inspection in September 2021. There was a structured process for clinical supervision and support.
  • A lack of effective clinical oversight and governance in relation to medicines management was identified through clinical searches of patients prescribed medicines that require routine monitoring.
  • Medicine safety alerts were not consistently acted upon which put patients at risk.
  • Improvement was still needed to strengthen the governance arrangements in place and improve quality monitoring systems.

We found one breach of regulations. 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.

Details of our findings and the evidence supporting our judgements 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 2021

During an inspection looking at part of the service

We carried out an announced inspection at Brook Medical Centre on 10 September 2021.

The key questions are rated as:

Safe - Requires Improvement

Effective – Requires Improvement

Well-led - Requires Improvement

This inspection was to follow up on the Requires Improvement rating at the last inspection in November 2019 when the practice was found to be Requires Improvement in Safe and Well-led and Requires Improvement overall. The practice was also found to be in breach of Regulation 17 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014. At our inspection in February 2020, we issued the provider a requirement notice under Regulation 17: Good Governance due to the areas of non-compliance we found. At this inspection, we looked across the three key questions above in order to assess the improvements which were required following our last inspection.

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

Why we carried out this inspection

This inspection was a focused follow-up inspection to follow up on:

In November 2019, we rated the practice requires improvement for providing safe and well-led services due to issues around managing the premises, patient safety and governance at the practice. The practice also needed to improve clinical oversight and monitoring.

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 Requires Improvement overall and Requires Improvement for population groups, people with long-term conditions, working age people, people experiencing poor mental health. We have rated older people, families, children and young people and people whose circumstances make them vulnerable as Good.

We found that:

  • Medicine safety alerts were not consistently acted upon which put patients at risk.
  • Recruitment checks were not fully documented and there was a lack of risk assessing in this area.
  • Emergency medicines were not all in stock as recommended and there was a lack of risk assessment to mitigate any risks.
  • Staff training, vaccinations and medical indemnity was not being adequately monitored.
  • There was no structured process of staff supervision and support.
  • Improvement was needed to strengthen the governance arrangements in place and improve quality monitoring systems.
  • The practice had made the required improvements in relation to clinical waste and emergency equipment and we found this to be in order.
  • 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.
  • There were effective systems in place to ensure that significant events and incidents were recorded and that learning was shared as a result of these.
  • There were some good systems in place to safeguard vulnerable patients, although staff training was not up-to-date in this area.

We found one breach of regulations. 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 taking action to improve the uptake of cervical 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

6 November 2019

During a routine inspection

We carried out an announced comprehensive inspection at Brook Medical Centre on 6 November 2019 as part of our inspection programme. This was the first inspection at the practice under it’s current registration.

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 requires improvement overall.

We rated the practice as requires improvement for providing safe and effective services because:

  • The practice did not have clear systems and processes to keep patients safe.
  • Receptionists had not been given sufficient guidance on identifying deteriorating or acutely unwell patients. They were not always aware of actions to take in respect of such patients.
  • There was no fire risk assessment, health and safety risk assessment or premises risk assessment in place.
  • Staff were not clear on who the safeguarding lead was at the practice.
  • There was limited monitoring of the outcomes of care and treatment and more clinical oversight was needed.
  • Some performance data was below local and national averages.

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

We rated the practice as requires improvement for providing well-led services because:

  • Some of the overall governance arrangements were ineffective due to a lack of clinical oversight.
  • The practice did not have clear and effective processes for managing risks, issues and performance.
  • The practice did not always act on appropriate and accurate information.

These areas affected all population groups so we rated all population groups as requires improvement.

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.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Ensure clinical waste is safely managed in line with the practice’s policy.
  • Review information and awareness for reception and administrative staff in relation to recognising and managing sepsis.
  • Review arrangements for storing blank prescriptions safely.
  • Strengthen the induction process for locum GPs and the supervision and appraisal system for all staff working at the practice.

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