Lance Lane Medical Centre

We carried out an announced inspection at Lance Lane Medical Centre on 24 May 2022. Overall, the practice is rated as Good.

Set out the ratings for each key question

Safe - Requires Improvement

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

This was the first inspection of Lance Lane Medical Centre following a change to the provider in November 2020 when the provider changed to Dr Venkata Sireesha Sreeguru. Dr Venkata Sireesha Sreeguru was a registered partner for the previous provider, Lance Lane Medical Centre. Under the previous provider this service was inspected on 03/12/2015 and was overall Good and requires improvement in Safe. A follow up inspection on 10/10/2016 found the service to be Good in Safe.

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

Why we carried out this inspection

We carried out this inspection as it has not been inspected since the change in registered provider. This inspection was a comprehensive review of information which included a site visit.

How we carried out the inspection

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 site visit

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 Good overall.

We have rated the practice as Requires Improvement for providing Safe services because recruitment was not always carried out according to Schedule 3 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found that:

• The required information to demonstrate staff were safely recruited was not available.
• The practice had current staffing vacancies. Staff told us that at times they did not feel there were sufficient clinical staff. Staff reported problems with reliability of locum staffing and locum staff not always completing similar tasks to employed clinicians which affected workload and meant they were working over their contracted hours. Staff told us this was affecting morale.
• The provider told us how they were recruiting new staff and covered shortfalls with locum, Primary Care Network and existing staff.
• Overall, patients received care and treatment that met their needs. However, improvements were needed to improve the uptake of patients receiving childhood immunisations and cervical screening.
• There was a system to share important information across the staff team. A better system of clinical meetings was needed to ensure all staff benefitted from these. Some meetings were informal and not all staff were able to attend due to their working patterns.
• There was a system to monitor essential staff training and records showed staff had received an appraisal.
• Staff told us how care was delivered and reviewed in a coordinated way when different teams, services or organisations were involved.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• A review of the appointment system indicated patients had access to care and treatment in a timely way. Improvements to the appointment system were planned.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
• The provider demonstrated they had made changes to the practice as a result of listening to staff and patients.
• The provider had plans in place to address shortfalls in staffing, immunisation and cervical screening rates and they told us about the improvements they were making to enable better staff information sharing and support.

We found one breach of regulations. The provider must:

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

Whilst we found no breaches of regulations, the provider should:

• Continue with the plans to recruit further staff to improve staffing levels.
• Appoint an infection prevention and control lead and ensure they have access to on-going guidance and support from infection prevention and control specialist staff.
• Introduce a system to formally document the monitoring of consultations, referrals and prescribing of clinicians.
• Continue to carry out medication audits to identify patients who require health monitoring.
• Review prescription management to enable identification of which clinician they have been allocated to.
• Continue to monitor and improve childhood immunisation and cervical screening uptake.
• Introduce further opportunities for all clinicians to be involved in clinical information sharing and to take part in discussions around significant events.
• Carry out a patient survey and use this feedback to review access arrangements.

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