Archived: Newhall Medical Practice - Newhall Street

Updated 28 August 2018

We carried out this inspection on the 28 June 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Newhall Medical Practice services are provided to patients under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation. Therefore, at Newhall Medical Practice, we only inspected the services delivered under the regulated activities.

Newhall Medical Practice - Newhall Street registered with CQC in 2010 under the provider organisation The Newhall Medical Practice Limited. It is an independent health care provider which provides private travel health services and private GP consultations which are registerable with CQC. However the service predominately provides Occupational Health Services, the provider estimates that approximately 90% of their activity is related to the provision of Occupational Health with relatively few patients accessing regulated services. The service is available to people over the age of 16 years.

The practice became part of the occupational health provider organisation BHSF in 2015 and moved from the registered address in May 2018 to Cornerblock, 2 Cornwall Street, Birmingham B3 2DL. These changes had not been reflected in the CQC registration, the provider has been made aware that this is a breach in the conditions of their registration.

The service is open for appointments Monday to Friday between 8am and 5.30pm. Staffing consists of three occupational health physicians, two sessional GPs (currently covering two sessions per week) and two nurses (covering six sessions per week for occupational health and travel services) supported by an administrative team. There is an Operations Manager and Clinical Standards Manager who also support the running of the service.

The service is registered with CQC under the Health and Social Care Act 2008 to provide the regulated activities of diagnostic and screening procedures and for the treatment of disease, disorder or injury.

The current registered manager is the Operations Manager however the service is in the process of changing the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

When we visited the service on the 28 June 2018 the inspection team consisted of a lead CQC inspector and a GP Specialist advisor to CQC.

Before visiting, we reviewed information we gathered from the provider through the provider information return and other information we hold about the service. During the inspection we spoke with the Chief Medical Officer, Operations Manager, Clinical Standards Manager and a nurse.

As part of our inspection we also asked for CQC comment cards to be completed by patients prior to our inspection. We received six completed comment cards where people who used the service shared their views and experiences of the service. All comments received were positive about the service.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 28 August 2018

We carried out an announced comprehensive inspection on 28 June 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

The impact of our concerns is minor for patients using the service, in terms of the quality and safety of clinical care. The likelihood of this occurring in the future is low once it has been put right.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations.

The impact of our concerns is minor for patients using the service, in terms of the quality and safety of clinical care. The likelihood of this occurring in the future is low once it has been put right.

Our key findings were:

• The provider carried out travel vaccinations and private GP consultations as part of their regulated activities with CQC.
• The systems to keep patients safe and safeguarded from abuse needed improving. We identified several areas where risks in relation to the management of safe services had not been sufficiently managed or embedded within the service.
• The premises had recently been refurbished prior to a recent move and appeared well maintained and visibly clean and tidy.
• The provider had arrangements for the safe management of medicines.
• Incidents were acted on and used to support learning.
• Staff were supported with their learning and development needs and had access to training and regular appraisals. However, the provider had not clearly identified core training needs of all staff or had effective systems for monitoring this.
• There was evidence of clinical improvement activity, while this predominantly related to services that were outside the scope of CQC regulation it was relevant to the regulated services.
• The provider had effective systems for obtaining consent and patient information was appropriately documented.
• Feedback from people about the service they received was positive. People who had used the service felt involved in decisions and said that they were treated with dignity and respect.
• People who used the service received timely care.
• There was a complaints process and complaints seen were appropriately managed.
• There was clear leadership to support the running of the service. However, governance arrangements did not adequately identify and address all areas of risks relating to the regulated activities. The provider had also failed to properly register their services.

We identified regulations that were not being met and the provider must:

• Ensure patients are protected from abuse and improper treatment.
• Ensure effective systems and processes are established to ensure good governance in accordance with the fundamental standards of care.
• Ensure the service is properly registered with CQC.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

• Review systems in place for supporting patients who may experience barriers to accessing information.
• Review prescribing guidance to include what medicines will or will not be prescribed through the private GP service.