• Doctor
  • Independent doctor

The Lanes Medical Practice

Overall: Good read more about inspection ratings

Plough Lane, Stoke Poges, Buckinghamshire, SL2 4JW (01753) 662244

Provided and run by:
Nicholas Edward Cheese

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about The Lanes Medical Practice on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about The Lanes Medical Practice, you can give feedback on this service.

10 August 2020 - We have not revisited the service as part of this review because the service was able to demonstrate that they were meeting the regulations associated with the Health and Social Care Act 2008 without the need for a visit.

During an inspection looking at part of the service

We previously carried out an announced comprehensive inspection at The Lanes Medical Practice on 2 October 2019 as part of our inspection programme. We rated the service as Good overall, however we found a breach of regulation and rated the provision of well-led services as Requires Improvement. You can read the full report by selecting the ‘all reports’ link for The Lanes Medical Practice on our website at .

On 10 August 2020, we carried out a desk-based review to confirm that the service had carried out its plan to meet the legal requirements in relation to the breach of regulations that we identified at our previous inspection in October 2019. This report covers our findings in relation to those requirements.

We are mindful of the impact of Covid-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what type of inspection was necessary and proportionate, this was therefore a desk-based review.

We found that the service was now meeting those requirements and we have amended the rating accordingly. The overall rating for The Lanes Medical Practice remains Good and is now rated Good for the provision of Well-led services. We previously rated the service as Good for providing Safe, Effective, Caring and Responsive services.

We based our judgement of the quality of care at this service on a combination of:

  • Information submitted by the provider, this included information relating to changes to patient identity and verification policies and procedures. We also saw a random sample of anonymised patient records to ensure the new operating model was embedded. All were relevant to demonstrate the service had addressed the breach of regulation identified at the inspection of October 2019.

We have rated Well-led as Good because:

  • Following the October 2019 inspection, we saw the provider had amended the operating model for the private GP service element of The Lanes Medical Practice. This amendment was an additional verification check when completing patient identity checks. On accessing the service patient identity was verified as patients were now required to provide photo identity such as driving licence or passport alongside proof of address. This amendment aligned to the revised governance policies within the service.

The service had also made improvements since the last inspection, for example:

  • Completed the planned training programme to ensure all members of staff were trained to an appropriate level of safeguarding training (in line with current safeguarding intercollegiate requirements) for their role and responsibilities.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of General Practice

2 October 2019

During a routine inspection

This service is rated as Good overall.

The previous inspection was in April 2018.

The inspection report for the previous inspection can be found by selecting the ‘all services’ link for The Lanes Medical Practice on our website at www.cqc.org.uk.

Since the April 2018 inspection, our methodology to regulate independent doctors and clinics providing primary care services has changed, the October 2019 inspection was therefore a rated inspection and the key questions are rated as:

•Are services safe? – Good

•Are services effective? – Good

•Are services caring? – Good

•Are services responsive? – Good

•Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at The Lanes Medical Practice in Stoke Poges, Buckinghamshire on 2 October 2019.

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.

The Lanes Medical Practice is registered with Care Quality Commission (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 regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Some of the services available at The Lanes Medical Practice, for example private GP service provision to patients under arrangements made by their employer and a government department, are exempt by law from CQC regulation.

Therefore, we were only able to inspect the services (private GP service and travel health services) which are not arranged for patients by their employers and government departments as part of this inspection.

The provider is an individual registered with CQC to manage the service. Individuals registered have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection, we received four completed comment cards which were all positive about the standard of care they received. The service advised due to the limited range of services (approximately 90% of the services provided are exempt from CQC regulation), the number of completed cards aligned to the size of the services we inspected.

All the comment cards were positive, further comments highlighted patients were satisfied with the standard of care received and thought the GPs and nurse were approachable, committed and caring. Several comments highlighted the wealth of knowledge within the travel health clinic which was easily accessible.

Our key findings were:

  • The service had clear systems to keep people safe and safeguarded from abuse. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
  • Patients received effective care and treatment that met their needs.
  • The way in which care was delivered was reviewed to ensure it was delivered according to best practice guidance.
  • For patients accessing the travel health clinic, the GPs and nurse recorded accurate travel plans including destinations, timescales and the reason for travel.
  • All patient feedback was overwhelmingly positive, this included archived patient feedback recorded by the service included a variety of patient testimonials.
  • Both the private GP services and travel health services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.
  • There were clear responsibilities, roles and systems to support good governance and management. However, the governance arrangements and supporting processes to verify patient identity required improvement.

The area where the provider must make improvements as there was a breach of regulations is:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. (Please see the specific details on action required at the end of this report).

In addition, the provider should:

  • Complete the planned training programme to ensure all members of staff are trained to the correct level of safeguarding training (in line with current safeguarding intercollegiate requirements) for their role and responsibilities.
  • Continue quality improvement activity for services subject to CQC regulation. This activity should include data evidencing improvement.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

5 April 2018

During a routine inspection

We carried out an announced comprehensive inspection on 5 April 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 providing safe care in accordance with the relevant regulations.

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 providing well-led care in accordance with the relevant regulations.

We carried out this inspection 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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The services inspected included provision of travel immunisations and private GP consultations for people who either sought a second opinion or access to an immediate appointment. Some patients also used the service to obtain a private health assessment. There was also a system in place for parents of patients aged under 16 to confirm their identity when these younger patients attended for travel immunisations.

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 The Lanes Medical Practice services are provided to patients under arrangements made by their employer and a government department. These types of arrangements are exempt by law from CQC regulation. Therefore, at The Lanes Medical Practice, we were only able to inspect the services which are not arranged for patients by their employers and government departments.

The provider is an individual registered with the Care Quality Commission to manage the service. Individuals registered have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Prior to the inspection we asked for feedback from patients by providing CQC comment cards to the practice four weeks in advance. We received 17 completed CQC feedback cards. All the patients who provided feedback were positive about the service they received. Patients described the service as caring, personalised and professional.

Our key findings were:

  • Systems were in place to protect people from avoidable harm and abuse.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Information about the service and how to complain was available.
  • There was a clear leadership structure and staff felt supported by the provider and worked very well together as a team. The provider was aware of the Duty of Candour.
  • The premises were appropriate to the service delivered and were accessible to clients with mobility difficulties.
  • There were appropriate arrangements in place to share information with the patients’ registered GPs.
  • There was an effective system to deal with blood samples and test results.
  • The system in place to receive feedback from patients did not include those patients receiving services subject to regulation.

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

  • Review and improve the process in place in relation to the use of patient group directions for administration of vaccines to ensure this is in line with National Institute for Health and Care Excellence (NICE) guidance.
  • Improve quality improvement methods to carry out medicines audits to include antibiotics and hypnotics.
  • Monitor the effectiveness and sustainability of the changes made to procedures at the time of, and immediately following, inspection.
  • Review the processes in place to obtain and act upon patient feedback from patients receiving services subject to regulation.

13 June 2013

During a routine inspection

We carried out an inspection on 07 February 2013 and published a report setting out our judgements. We asked the provider to send us a report of the changes they would make to comply with the standard of cleanliness and infection control. We followed up on our inspection of 07 February 2013 to check that action had been taken to meet this standard.

We were not able to speak to people as part of this inspection.

In February we found failings in the standard of cleaning. Since then the provider had made changes to ensure the premises were cleaned appropriately. When we visited in June we found the premises were clean, tidy and well maintained.

The service had a small number of employed staff. Recently a second doctor had joined the practice to provide occasional cover for the principal doctor. We found not all the required recruitment checks had been carried out and documented.

There was a complaints procedure in place although the service did not have any complaints recorded.

7 February 2013

During a routine inspection

We spoke to three people who used the service during our visit. They all spoke positively of their experiences and the care they had received. One person told us" The service is very comprehensive and I have no complaints at all." We found that the atmosphere within the practice was calm and people were treated with courtesy and given a personal service.

People were provided with full information about their treatments and had been able to make informed decisions about their care.

The premises were tidy and well maintained however we found that improvement was needed in the management of cleaning standards.

Clinical staff were trained and qualified to provide the service and administrative staff felt happy and supported in their work.

There was a system in place to monitor the running of the service and to implement improvements where feedback or learning from experience and events indicated there was scope to do so.

23 February 2012

During an inspection looking at part of the service

On this occasion we were not able to speak to anyone attending the clinic for treatment at the time of the visit, however we randomly selected four people who were all happy to speak to us on the phone after the inspection.

People told us they were happy with service provided by Lanes Medical Practice. They said they were informed about costs of treatment over the phone at the time of making the appointment. People said they felt the consultations were thorough and informative.