Background to this inspection
Updated
12 February 2020
RHR Medical Centre providers primary medical services to approximately 4,800 patients in the Strelley area of Nottingham. The practice is located at Calverton Drive, Strelley, Nottinghamshire, NG8 6QN.
The provider is registered for the provision of the following regulated activities from RHR Medical Centre:
Diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures, treatment of disease, disorder or injury.
RHR Medical Centre is part of JRB Healthcare which includes one other GP practice located within a close radius. Both practices hold a Primary Medical Services (PMS) contract with Nottingham City Clinical Commissioning Group (CCG) and each has a separate patient list. JRB Healthcare is registered with the Care Quality Commission (CQC) as a partnership between a GP and an advanced nurse practitioner.
RHR Medical Centre is situated in an area of high deprivation falling into the most deprived decile,
meaning that there is a greater demand for health services. Income deprivation affecting children and older people is above the local clinical commissioning group (CCG) and national averages.
The clinical team working at RHR Medical Centre comprises of regular GP locums, a practice nurse and a healthcare assistant. A full-time practice manager and a team of reception and administrative staff support the clinical team.
The practice is open between 8am to 6.30pm Monday to Friday. Patients could access extended access appointments at the other practice within JRB Healthcare or at GP+ based in Nottingham City Centre which is a local federation who offer extended access.
When the practice is closed out-of-hours GP services are provided by Nottinghamshire Emergency Medical Services (NEMS) which is accessed by telephoning the NHS 111 service.
Updated
12 February 2020
We carried out an unannounced focussed inspection at RHR Medical Practice on 18 June 2019 in response to concerns that were found at another practice which was part of the Beechdale Medical Group.
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 Requires Improvement overall and for all population groups.
We have rated the practice as requires improvement for providing safe services.
We found that:
- There were gaps in systems to assess, monitor and manage risks to patient safety.
- When things went wrong, reviews and investigations were not always sufficiently thorough. Improvements were not always identified.
- There were gaps in recruitment and training records of staff.
We have rated the practice as requires improvement for providing effective services.
We found that:
- Care and treatment was not always delivered in line with national guidance.
- There was no clinical oversight of clinicians and management were not aware of competencies of clinical staff.
- There was limited evidence of quality improvement.
We have rated the practice as requires improvement for providing well-led services.
We found that:
- The practice was transitioning through a change in management, and systems had not been embedded.
- The practice did not always act on appropriate and accurate information.
- We saw little evidence of systems and processes for learning, continuous improvement and innovation.
The areas where the provider must make improvements are:
- Ensure that care and treatment is provided in a safe way.
The areas where the provider should make improvements are:
- Ensure that staff recruitment files, training requirements and vaccination status are up to date including any checks on locum GPs.
- Ensure fire alarm checks are being carried out at the practice.
- Improve methods of quality improvement at the practice including learning from events and completing audits.
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
People experiencing poor mental health (including people with dementia)
Updated
24 July 2019