Background to this inspection
Updated
28 December 2018
We carried out an announced comprehensive inspection of the previous provider for RJ Mitchell Medical Centre on 6 February 2018 and 23, 27 and 30 April 2018. The practice was rated inadequate and place into special measures. Following our inspection, the provider submitted an application to cancel their registration with the Care Quality Commission and in May 2018 a new partnership provider took over the practice. The full comprehensive reports on the February and April 2018 inspections can be found by selecting the ‘all reports’ link for RJ Mitchell Medical Centre on our website at www.cqc.org.uk.
R J Mitchell Medical Centre is located at 19 Wright Street, Talke, Stoke-on-Trent, Staffordshire ST7 1NY. There is a branch surgery, Waterhayes Surgery which is located at 74 Crackley Bank, Chesterton, Newcastle, ST5 7AA. The practices have good transport links and there are pharmacies located nearby.
The provider is registered with CQC to deliver the Regulated Activities; diagnostic & screening procedures, treatment of disease, disorder or injury, maternity and midwifery services, family planning and surgical procedures.
R J Mitchell Medical Centre is situated within the North Staffordshire Clinical Commissioning Group (CCG) and provides services to approximately 4,455 patients under the terms of a General Medical Services (GMS) contract. A GMS contract is a contract between NHS England and general practices for delivering general medical services to the local community.
The practice employs two male GP partners, a business partner, a male salaried GP, two GPs (one female and one male) from the provider arm, a practice nurse and health care support assistant, pharmacist and pharmacy technician and 11 administrative staff covering a range of hours. The practice is part of a wider network of GP practices so additional GPs, managers and practice nurses provide additional support when required.
The practice area is one of average deprivation when compared with the national and local CCG area. Demographically the practice has a lower than average older patient distribution when compared with the CCG and national averages. For example, 14% of the practice population are 65 years and older compared with the CCG average of 22% and the national average of 17%. The general practice profile shows that the percentage of patients with a long-standing health condition is 60% which is slightly higher than the local CCG average of 57% and national average of 54%. National General Practice Profile describes the practice ethnicity as being 97.1% white British, 1.6% Asian, 0.3% black, 0.9% mixed and 0.2% other non-white ethnicities. Average life expectancy is 77 years for men and 83 years for women compared to the national average of 79 and 83 years respectively.
Updated
28 December 2018
We carried out an announced comprehensive inspection of the previous provider for RJ Mitchell Medical Centre on 6 February 2018 and 23, 27 and 30 April 2018. The practice was rated inadequate and placed into special measures. Following our inspection, the provider submitted an application to cancel their registration with the Care Quality Commission and in May 2018 a new partnership provider took over the practice. The full comprehensive reports on the February and April 2018 inspections can be found by selecting the ‘all reports’ link for RJ Mitchell Medical Centre on our website at www.cqc.org.uk.
We carried out an announced comprehensive inspection at RJ Mitchell Medical Centre on 12 December 2018 to ensure that the required changes had been made.
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 rated this practice as good overall and in all population groups except for people with long-term conditions which we rated as requires improvement.
We rated the practice requires improvement for people with long-term conditions because:
- 163 patients who had a potential diagnosis of pre-diabetes had not been coded correctly within the practice’s computer system or always followed up with the appropriate blood monitoring. It was not clear if they had been offered appropriate education, information or lifestyle advice to improve their health outcomes.
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs. An action plan to follow up patients with a potential diagnosis of pre-diabetes who had not been coded correctly was put in place following our inspection.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs. The practice had plans in place to improve access to appointments.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care. Changes within the practice were managed effectively.
The areas where the provider should make improvements are:
- Provide non-clinical staff with formal training in the identification of the rapidly deteriorating patient.
- Record the actions taken in patients’ records after following up failed attendance of children’s appointments following an appointment in secondary care.
- Continue to develop systems to demonstrate that appropriate information is shared with the out of hours service for patients nearing the end of their lives.
- Follow their action plan to code patients with a potential diagnosis of pre-diabetes correctly and record the action taken to improve health outcomes in patients’ records.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice