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Meanwhile Garden Medical Centre: A case study in improvement

Meanwhile Garden Medical Centre
  • Organisations we regulate

The Meanwhile Garden Medical Centre serves around 3,000 patients living in Kensington and Chelsea, west London.

When we inspected in July 2015 we rated the practice as inadequate overall and it was put into special measures.

During the latest inspection in April 2016, inspectors found that Meanwhile Garden had made significant improvements in patient care. As a result, we gave the practice a new rating of good overall and rated it good across four of our five key questions.

Improvement: from July 2015 to April 2016

Patient safety

What we found in July 2015

  • Patients were at risk of harm because systems to keep people safe were inadequate, including incident reporting, safeguarding, recruitment, infection control and medicine management.
  • There were no systems to monitor safety and respond to risk.
  • Although the practice carried out investigations when things went wrong, any lessons learned were not communicated, therefore safety was not improved.
  • The practice did not have an automated external defibrillator (for cardiac emergencies) and had not assessed the risks of not having this equipment.
  • There was no business continuity plan to deal with a range of emergencies that may impact on the daily operation of the practice and no buddy arrangements with other local practices.

What we found in April 2016

  • There was an open and transparent approach to safety and an effective system for reporting and recording significant events.
  • There was an effective system for reporting and recording significant events.
  • When things went wrong, patients received reasonable support, truthful information, and a written apology. They were told about any actions to improve processes to prevent the same thing happening again.
  • Risks to patients were assessed and well managed.
  • Systems, processes and practices to keep patients safe and safeguarded from abuse were clearly defined and embedded.

Staffing and leadership

What we found in July 2015

  • Leadership was fragmented and there was no clear leadership structure.
  • Staff told us they were not clear about their responsibilities in relation to the vision or strategy.
  • There was little evidence of practice meetings and issues were discussed informally.
  • Staff told us they had not received regular performance reviews and did not have clear objectives.
  • The practice had not proactively sought feedback from staff or patients and did not have a patient participation group (PPG).

What we found in April 2016

  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on
  • The practice had a clear vision to deliver high quality care and promote good outcomes for patients
  • There was a mission statement and staff knew and understood the practice's values
  • Staff assessed patients’ needs and delivered care in line with current evidence-based guidance
  • Staff had been trained so that they had the skills, knowledge and experience to deliver effective care and treatment.

Patient feedback and access to services

What we found in July 2015

  • Patients said they sometimes had to wait a long time to be seen.
  • The practice did not actively engage with patients and staff to gather feedback.
  • The practice had not reviewed the needs of its local population.
  • There was limited engagement with the clinical commissioning group (CCG) to discuss service improvements for patients.
  • Although there was information for patients about how to complain it did not explain the process properly.

What we found in April 2016

  • Patients said it was easier to make appointments.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • Information about services and how to complain was available and easy to understand.
  • The quality of care improved as a result of complaints and concerns being acted on.
  • The practice helped vulnerable patients to find out how to access various support groups and voluntary organisations.

During the latest inspection, inspectors found that patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

What they said

Juliet Payne, Practice Manager at Meanwhile Gardens Medical Centre, said:

“The surgery is delighted with the outcome of the recent inspection. This has been achieved through the high level of staff commitment to improve our facilities and services.

“Recognising that staff training was an important step to success, we have ensured that sufficient work time was allotted for this, in order not to encroach on staff members' free time.

“Our goal is to consistently improve, delivering the best care for our patients.”

Professor Steve Field, Chief Inspector of General Practice, said:

“It is clear that Meanwhile Gardens Medical Centre has made some real improvements since our previous inspection in July 2015, where we identified serious concerns relating to the safe delivery of services.

“The practice is now providing a safe, caring, responsive, well-led and effective service and I congratulate them on the progress that they have made.”

Ursula Gallagher, Deputy Chief Inspector of General Practice for the London region, said:

“When we inspected the practice in July we found improvements had been made.

“There is still some work to do and we shall continue to monitor the practice’s performance. I am confident that, if they keep going, Meanwhile Garden Medical Centre can set an example that others will follow.”


Last updated:
25 October 2016