Archived: Midlands Medical Partnership-Lea Village Medical Centre

This practice is rated as inadequate overall.

The key questions are rated as:

• Are services safe? – Inadequate
• Are services effective? – Inadequate
• Are services caring? – Requires Improvement
• Are services responsive? – Requires Improvement
• Are services well-led? - Inadequate

We carried out an announced comprehensive inspection at Midlands Medical Partnership-Lea Village Medical Centre on 4 April 2018 and 19 April 2018. The practice last received a comprehensive inspection under the previous provider on 30 September 2016 and received an overall rating of requires improvement. Prior to this, the practice had been in a period of special measures.

The current provider of this practice registered with CQC in July 2017.

The reason for this inspection was to follow up the concerns identified at our previous inspections of this practice and other concerns that had been identified prior to the new provider registering this practice. The inspection was to ensure the legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were being met.

At this inspection we found:

• The new provider had put in place a range of systems and processes to support the practice in the provision of safe and effective services. However, these were not well embedded and were not followed by all staff at the practice.
• Risks were not always well managed within the practice and we found weaknesses relating to safeguarding arrangements, infection control, management of medicines, medical emergencies and for acting on incidents and safety alerts.
• We identified concerns in relation to the quality of care provided and found care and treatment that was not consistent with evidence based guidelines.
• Evidence seen suggested most staff involved and treated patients with compassion, kindness, dignity and respect.
• There was mixed feedback from patients with regard to the appointment system, a small proportion of patients reported that they found it difficult to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Although we saw significant changes had been made to restructure and improve the management of the practice, the governance arrangements that had been put in place had failed to identify and address some of the poor clinical care identified during the inspection and that the provider systems and policies had not been implemented by the local practice.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.
• Ensure patients are protected from abuse and improper treatment.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Review the cause of delays in post being received and actioned to identify how this may be improved.
• Consider ways in which the identification of carers could be increased to ensure support is provided.
• Consider how the effectiveness and patient input into the practice could be improved.
• Review soundproofing of the main consulting room and how this may be improved.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice