The Care Quality Commission
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  • GP practice

Archived: Dr Manuel Enrique Martin Hierro Also known as Woodchurch Medical Centre

Overall: Requires improvement read more about inspection ratings

33 Poolwood Road, Wirral, Merseyside, CH49 9BP (0151) 606 1908

Provided and run by:
Dr Manuel Enrique Martin Hierro

Important: The provider of this service changed. See new profile

All Inspections

13 January 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Dr. Manuel Enrique Martin Hierro. The practice is registered with the Care Quality Commission to provide primary care services.

We undertook a planned, comprehensive inspection on 13 January 2015 at the practice location Woodchurch Medical Centre. We also followed up concerns that we found at the last inspection of this location in July 2014. We spoke with patients, relatives, staff and the registered provider.

The practice was rated overall as Requires Improvement. They provided care and treatment that addressed the needs of the diverse population it served however aspects of the service needed improvement.

Our key findings were as follows:

  • There were aspects of safety which needed improvement to ensure systems were fully embedded to keep patients safe from risks and harm. Incidents and significant events analysis and sharing of information needed improvement. Staff were safely recruited. Infection risks and medicines were generally managed safely.
  • Patients spoke highly of the practice. They told us staff were helpful and caring and treated them with dignity and respect.
  • The practice provided good care to its population taking into account their health and socio economic needs. Access to suitable, convenient appointments was good and patients had confidence in the practice staff. Complaints were managed appropriately.
  • Patients’ needs generally were assessed and care was planned and delivered in line with current legislation and guidance. However the practice needed to improve their recording of care and treatment in relation to patients who experienced poor mental health to ensure patients received appropriate care and treatment.
  • There was good team working evident. Staff enjoyed working for the practice and felt well supported and valued. Clinical Governance systems were in place however these were not fully embedded into practice to ensure continuous quality monitoring.

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

Have an effective system in place to regularly assess and monitor the quality of services provided. Have an effective system in place for identifying, assessing and managing risks related to the health and safety of service users and others. Have an effective system in place for reporting, analysing, learning from and disseminating significant events.

In addition the provider should:

  • Ensure all clinical staff, including practice nurses are trained to a higher level of safeguarding than non- clinical staff and that level should be relevant to their role.
  • Ensure the vaccine fridge is situated in a suitable safe location and that the fridge plug is labelled warning people not to inadvertently unplug it.
  • Improve recording of care and treatment for patients with poor mental health to ensure they are reviewed and monitored regularly and that information regarding their health is gathered. Ensure any informal patient drop in sessions are fully documented.
  • Ensure medical equipment and portable electrical appliances are regularly calibrated, tested and maintained.
  • Hold regular documented multi-disciplinary meetings occur to discuss care and support for palliative care patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

8 July 2014

During an inspection looking at part of the service

Dr Martin-Hierro was suspended from the clinical performers list by NHS England due to concerns with his clinical practice. We carried out this inspection to follow up the non-compliance identified at the previous inspection in March 2014. We had found concerns of varying degree in seven outcome areas. We took enforcement action and told the provider Dr Manuel Enrique Martin- Hierro to improve in order to protect the health, safety and welfare of patients who used the service.

At this inspection the provider Dr Martin-Hierro continued to be suspended from clinical practice and was not clinically active. GP services were provided by locum GPs and the practice was supervised and assisted by a neighbouring practice employed by NHS England. We found that improvements had been made and that most of the standards were being met. However there were still improvements needed.

Patients and staff told us that care and treatment had improved in the last few months. We found evidence to support this. Patient's care and treatment plans were appropriate with timely investigations and referrals evident. Results and communication from secondary and other care providers was acted upon in a timely manner to ensure patient safety and well-being.

Improvements were required in order to ensure that staff were appropriately recruited and were suitable for their role.

We found that staffing levels were just suitable however there was a risk that levels may become unsafe in the case of absences of regular staff.

Staff felt supported and training needs had been identified and commenced. However mandatory training needed to include more topics that were important for the role. Regular documented staff meetings were not taking place in order to ensure appropriate exchange of information and dissemination of lessons learnt to encourage improvement in service provision.

Improvements were needed to the monitoring of quality and risk management. Accident /incident reporting had improved and attempts made to commence a patient participation group. Complaints systems and processes were functioning as required. Policies and procedures were localised and staff were aware of them.

Records were now managed safely.

3 March 2014

During an inspection in response to concerns

An inspection at the practice was undertaken due to information of concern received about the care and welfare of patients. This was mainly in relation to the delay in referrals to other health professionals, such as specialist referrals to hospitals. We undertook this visit with a specialist advisor who had experience of working within a GP practice.

Care and treatment was provided in an environment which was clean and organised. There was a small waiting area, where patients had access to a limited number of health promotion and information leaflets.

We found electronic alerts on patient records were out of date but we found evidence that the system to refer patients to other health professionals had improved.

Consultations were appropriately recorded, dated and the name of the GP or practice nurse was documented.

We found inconsistent and ineffective use of the EMIS patient records system.

We saw there was a current recruitment policy in place however the practice was not adhering to this.

When we spoke with patients comments included: 'All my family are patients here, we have nothing but praise for the Dr, he has always been there for us' and 'We have no trouble at all getting appointments'. However satisfaction with the service was not consistent.