Archived: R J Mitchell Medical Centre

We carried out an announced comprehensive inspection of the previous provider for RJ Mitchell Medical Centre on 6 February 2018 and 23, 27 and 30 April 2018. The practice was rated inadequate and placed into special measures. Following our inspection, the provider submitted an application to cancel their registration with the Care Quality Commission and in May 2018 a new partnership provider took over the practice. The full comprehensive reports on the February and April 2018 inspections can be found by selecting the ‘all reports’ link for RJ Mitchell Medical Centre on our website at www.cqc.org.uk.

We carried out an announced comprehensive inspection at RJ Mitchell Medical Centre on 12 December 2018 to ensure that the required changes had been made.

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 this practice as good overall and in all population groups except for people with long-term conditions which we rated as requires improvement.

We rated the practice requires improvement for people with long-term conditions because:

• 163 patients who had a potential diagnosis of pre-diabetes had not been coded correctly within the practice’s computer system or always followed up with the appropriate blood monitoring. It was not clear if they had been offered appropriate education, information or lifestyle advice to improve their health outcomes.

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. An action plan to follow up patients with a potential diagnosis of pre-diabetes who had not been coded correctly was put in place following our inspection.
• 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. The practice had plans in place to improve access to appointments.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care. Changes within the practice were managed effectively.

The areas where the provider should make improvements are:

• Provide non-clinical staff with formal training in the identification of the rapidly deteriorating patient.
• Record the actions taken in patients’ records after following up failed attendance of children’s appointments following an appointment in secondary care.
• Continue to develop systems to demonstrate that appropriate information is shared with the out of hours service for patients nearing the end of their lives.
• Follow their action plan to code patients with a potential diagnosis of pre-diabetes correctly and record the action taken to improve health outcomes in patients’ records.

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