Lanchester Medical Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

At our last assessment, we rated this key question as inadequate. At this assessment, the rating has changed to Good.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

In July 2025, we found significant risk of future harm to patients due to ineffective management and oversight of long-term conditions. The clinical governance arrangements lacked the necessary oversight and effectiveness, which increased the potential for patient harm.

At this inspection, we found significant improvements had been made. We found assessment and recall of patients with long term conditions had improved. Clinical records we saw demonstrated care was now provided in line with current guidance in most cases. However, we found some patients prescribed oral steroids for acute exacerbation of asthma were not reviewed within best practice timescales. Although these patients had been advised to contact the practice if they did not improve, it is best practice to arrange a follow up appointment to check on them.

Since the last CQC inspection, we had continued to receive feedback from patients of clinical concerns following consultations. One theme that emerged in the lead up to the announced inspection related to concerns about clinical records, with concerns about inaccurate information recorded. For example, recording that they had been contacted as part of a medicine review, when no contact had taken place. The patient participation group had also raised this concern with the practice. The provider was exploring how to address this concern. We did not find any similar themes of concerns within our clinical searches. However, we asked the provider to give an account of how they were addressing these concerns. They told us they had reviewed their processes against those in place across other practice in the primary care network (PCN). They found the processes in place were consistent with those across the PCN. The practice used standardised templates to record clinical assessments. They reviewed the process with staff and considered how clinical records relating to administrative and medicines optimisation would show to patients. As a result, they had developed some communication to explain these to patients. They told us they had shared this information with the patient participation group and has prepared an update for the practice website. They told us they continued to participate in audit and quality assurance processes across the PCN to gain assurance they were working consistently and in line with local working practices.

Reception staff were aware of the needs of the local community. Reception staff used digital flags within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present. Staff checked people’s health, care, and wellbeing needs during health reviews. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. The provider had effective systems to identify people with previously undiagnosed conditions. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

At our last inspection, we found the service did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards. At this inspection, we found improvements had been made. The provider had implemented clinical templates to guide staff in providing safe and effective care in line with national guidelines. There were improved arrangements for sharing and implementing best practice from NICE and other clinical guidance. Whilst leaders told us NICE guidelines were discussed at team meetings and supervision sessions, and these were included as an agenda item; notes of meetings we reviewed did not include any examples of these being discussed.

Clinical records we saw demonstrated care was provided in line with current guidance.

The service did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

In July 2025, we found the service did not always work well across teams and services to support people. At this inspection, we found that working relationships within the practice were still strained and the culture within the practice did not always support positive and productive working relationships. However, there had been some improvements, with regular clinical meetings and clinical supervision sessions for staff to share knowledge and seek advice and feedback about their clinical practice.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services. We received positive feedback from other healthcare professionals about the improvements that had been made, including in relation to ward rounds at the linked local care home. Whilst not all issues had been resolved, the improvement to communication and structure was noted. However, we identified concerns that there was a lack of engagement and attendance at practice safeguarding meetings by some relevant healthcare partners, which potentially placed vulnerable patients at risk of harm. The practice had escalated this issue via the regional incident recording systems.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

In July 2025, we found the service did not support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. In April 2026, we found there were improvements to the support for people with long term conditions.

Staff focused on identifying risks to patients’ health, including those in the last 12 months of their lives, patients at risk of developing a long-term condition and those with caring responsibilities. Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity.

The service had begun monitoring care and treatment to support continuous improvement; however, further time was needed to demonstrate that these changes were effective and fully embedded.

At our last inspection we found the provider did not monitor people’s care and treatment or ensure outcomes were positive and consistent. Whilst at this inspection, we found significant improvements had been made to the standard of health care provided, there was not yet sufficient evidence to demonstrate continuous embedded quality improvement. From the clinical notes we reviewed, we found that people who used the service now experienced healthcare outcomes as set out in legislation, standards, and evidence-based clinical guidance.

Although recent clinical audits had been conducted these did not yet evidence the full audit cycle to demonstrate benefits had been realised.

The practice met national targets for screening and immunisations.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood and applied legislation relating to consent. Capacity and consent were recorded.