The Care Quality Commission
  • Doctor
  • GP practice

King Street Medical Centre

Overall: Good read more about inspection ratings

43 King Street, Accrington, Lancashire, BB5 1QE (01254) 617664

Provided and run by:
King Street Medical Centre

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

All Inspections

26 July 2023

During an inspection looking at part of the service

We carried out an announced follow up inspection at King Street Medical Centre on 19 and 26 July 2023. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring – Not inspected. (Rated Good July 2022)

Responsive - Good

Well-led - Good

This inspection was a follow up focused inspection. We had previously inspected the GP service on 26 and 27 July 2022. That inspection identified shortfalls in meeting the required standards and the GP practice was rated as requires improvement overall with key question safe rated as inadequate. Key questions effective and well led were rated as requires improvement with caring and responsive key questions rated as good. We issued a warning notice for breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Safe care and treatment) and a requirement notice for breach of regulation 17 Good Governance. A follow up inspection to review the actions taken by the GP practice in relation to the warning notice (regulation 12 breach) was carried out in November 2022. This showed improvements in all the areas identified within the warning notice for breach of regulation 12 Safe care and treatment.

The inspection reports for this service can be found by selecting the ‘all reports’ link for King Street Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection.

We carried out this inspection to follow up breaches of regulation from a previous inspection undertaken in July 2022. At this inspection we reviewed 4 key questions: safe, effective, responsive and well led. We found that:

  • Improvements observed at the inspection in November 2022 for safe patient prescribing, medicine reviews and the monitoring of fridge temperatures to maintain the cold chain for the safe storage of vaccines had been sustained.
  • This inspection identified that all clinical staff were trained to the required safeguarding level; recruitment records were completed appropriately; staff training had been undertaken in infection prevention and control (IPC) and an audit had been undertaken.
  • A system of staff appraisal was now in place. Systems to ensure patients with a chronic or long term health condition were established and gaps in the governance arrangements had been addressed.

How we carried out the inspection

Our inspection included:

  • Conducting staff interviews using video conferencing, as well as face to face.
  • Reviewing feedback received by the CQC regarding the service.
  • Completing clinical searches on the practice’s patient records system remotely (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.
  • Reviewing evidence from the provider, including the action plan following the inspection in July 2022.
  • Reviewing data available in the public domain.
  • A 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 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 team recognised the challenges of ensuring patient access to the right clinical care and treatment and was working with the primary care team on a quality improvement initiative to seek ways to improve patient access to timely appropriate care and treatment.
  • The way the practice leadership team worked with their staff promoted the delivery of high-quality, person-centre care.

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

  • Update children’s safeguarding records to include information of all people living within the household.
  • Record clearly for patients on their prescription the day they should take their medicine that was prescribed for once a week.
  • Change the floor covering on the first floor of the GP practice as planned.
  • Continue to recruit people to the Patient Participation Group (PPG).
  • Continue implementing strategies to improve patient uptake in areas of cervical screening and child immunisations.
  • Include the contact details of the Parliamentary and Health Service Ombudsman (PHSO) at the end of final written complaint responses.

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 Health Care

27 July 2022

During a routine inspection

We carried out an announced inspection at King Street Medical Centre on 27 July 2022 Overall, the practice is rated as requires improvement.

Set out the ratings for each key question

Safe - Inadequate

Effective - Requires improvement

Caring - Good

Responsive - Good

Well-led - Requires Improvement

This was the first inspection of this GP practice under this registered provider.

Why we carried out this inspection.

This inspection was a comprehensive rating inspection where we reviewed all five key questions.

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 included:

  • Conducting some staff interviews using video conferencing as well as face to face.
  • 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 site visit.
  • Obtaining feedback from patients and staff.

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

We rated the practice as inadequate for providing safe services because:

  • Clinical monitoring checks such as blood test had not been undertaken for some patients.
  • Patients records to support the prescribing of high risk medicines such as steroids did not demonstrate an assessment of the patients’ health and wellbeing had been carried out.
  • Medication reviews were not recorded to a consistent safe standard.
  • No action in response to raised pharmaceutical temperatures for two fridges had been taken.

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

  • Systems of quality assurance were in the early stages of development and there was gaps identified staff recruitment records and training records for clinicians.
  • A system to log actions undertaken in response to patient safety alerts was not in place.

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

  • Staff told us they were committed to working as a team and providing a good quality service. Staff told us the GP practice was a good place to work and they were supported.
  • One patient we spoke with was wholly positive about the care and treatment they and their family received.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic and continued to do so now restrictions had changed.

We found two breaches of regulations.

The provider must:

  • 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.

The provider should:

  • Move emergency medicines to maintain security whilst maintaining easy accessibility in the event of an emergency.
  • Provide more secure window coverings in both consultation rooms.
  • Look to increase the number of advanced clinicians at the practice and develop and succession plan.
  • Explore ways of involving patients in how the service is delivered and continue to canvas patients to restart a Patient Participation Group (PPG).
  • Monitor performance for childhood immunisations and continue to promote uptake of cervical screening.

Details of our 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.