The Care Quality Commission
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  • GP practice

Welling Medical Practice

Overall: Requires improvement read more about inspection ratings

2 Danson Crescent, Welling, Kent, DA16 2AT 0844 477 0970

Provided and run by:
Welling Medical Practice

All Inspections

7, 8 and 10 September 2021

During a routine inspection

We carried out an announced inspection at Welling Medical Practice on 7 September 2021. Overall, the practice is rated as Requires improvement.

Set out the ratings for each key question

Safe - Requires improvement

Effective – Good

Caring - Requires improvement

Responsive - Requires improvement

Well-led - Good

Following our previous inspection on 28 July 2015, the practice was rated as Good overall and for four of the five key questions. We rated the practice as requires improvement for providing safe services. After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breach of regulation 12(1)(2)(b)(d)(g)(h) Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We undertook a desk-based focussed inspection on 1 April 2016 to check that they had followed their plan and confirmed that they now met the legal requirements.

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

Why we carried out this inspection

This inspection was a comprehensive inspection, as there had been organisational changes at the practice since our last inspection.

How we carried out the inspection/review

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
  • Obtaining staff feedback via completed questionnaires

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 for all population groups. The practice is rated Good for providing Effective and Well led services.

We found that:

  • Patient feedback via the national GP patient survey showed the practice was scored poorly in several areas including experiences of making an appointment, interactions with staff, and overall experience of the GP practice.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. They had moved to a digital first approach to accessing services, with patients being encouraged to complete an online consultation in the first instance. Other forms of access was available to patients who could not use the online consultation system.
  • The practice was a training practice, and was led by a stable and established leadership team.

We found 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 of care.

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

1 April 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the practice on 28 July 2015. Breaches of legal requirements were found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breach of regulation 12(1)(2)(b)(d)(g)(h) Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this desk-based focussed inspection on 1 April 2016 to check that they had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements and also where additional improvements have been made following the initial inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Welling Medical Practice on our website at www.cqc.org.uk.

Overall the practice is rated as Good. Specifically, following the focussed inspection we found the practice to be good for providing safe services. As the practice was now found to be providing good services for safety, this affected the ratings for the population groups we inspect against. Therefore, it was also good for providing services for older people; people with long-term conditions; families, children and young people; working age people (including those recently retired and students); people whose circumstances make them vulnerable and people experiencing poor mental health (including people with dementia).

Our key findings across all the areas we inspected were as follows:

  • Risks to patients were assessed and well-managed, including those related to medicines management, infection control and responding to emergencies.

However there were areas of practice where the provider should make improvements:

  • Ensure that the practice has a system for ensuring monitoring of refrigerator temperatures every day that the practice is open, in line with recommended guidance.
  • Ensure that clinical staffing levels are appropriately planned and monitored.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

28 July 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Welling Medical Practice on 28 July 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Our key findings across all the areas we inspected were as follows:

  • There were arrangements for identifying, recording and managing risks and implementing mitigating actions.
  • Most risks to patients were assessed and well managed, with the exception of those relating to medicines management and responding to emergencies.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • Data showed that patient outcomes were average or above for the locality. Some clinical audits had been carried out, with evidence that they were driving improvement in performance to improve patient outcomes.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Urgent appointments were available on the day they were requested. However, patients said that they had difficulty accessing an appointment with a named GP.
  • Information about services and how to complain was available and easy to understand.
  • Policies and procedures were in date and were accessible for staff.
  • There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on.
  • The practice had an established and active patient participation group (PPG).
  • There was evidence of learning and improvement within the practice from incidents, complaints, audits and risk assessments, but these were not always linked together to identify themes. Action points were not always monitored effectively to demonstrate that improvements in the practice had been successful.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider must:

  • Ensure that the practice has systems in place to be able to appropriately respond to emergencies, including access to a defibrillator.
  • Ensure the practice’s medicines management policy is followed including adequate monitoring of vaccine refrigerator temperatures and prescription pads.
  • Ensure there are adequate infection control processes in place to include infection control training for staff and monitoring of the control of substances hazardous to health (COSHH).

In addition the provider should:

  • Ensure that the practice has a clear incident reporting policy for staff to refer to.
  • Ensure that clinical staffing levels are appropriately planned and monitored.
  • Further improve access to appointments with a patient’s preferred GP.
  • Ensure that complaints are responded to in an appropriate manner.
  • Ensure that there are systems in place to monitor actions taken as a result of learning and improvements, to demonstrate that changes in the practice have been successful.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice