You are here

Archived: MEEBBB Health CIC (St Pauls Way Medical Centre) Outstanding

Reports


Inspection carried out on 26 November 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

MEEBBB (Mile End East and Bromley by Bow) Health CIC (St Pauls Way Medical Centre) provides GP primary medical services to approximately 10,500 patients living in the London Borough of Tower Hamlets. The practice is a Community Interest Company run by representatives from four other local GP practices.

We carried out an announced comprehensive inspection on 26 November 2014. The inspection took place over one day and was undertaken by a lead inspector, a second CQC inspector and two GP Specialist Advisors. We looked at care records, spoke with patients, members of the patient participation group (PPG) and staff including the management team.

Overall the practice is rated as outstanding.

Specifically, we found the practice to be outstanding for providing effective, responsive services and for being well led. It was rated Good for providing safe and caring services.

Our key findings across all the areas we inspected were as follows:

  • The service is safe. Systems including incident reporting protocols, safeguarding measures and infection control procedures were in place to keep patients safe.

  • The service is effective. Staff were appropriately qualified to deliver effective care and treatment in line with NICE guidance and they shared best practice with external consultants and other GP practices.

  • The practice is caring. Patients said that staff were welcoming, caring and treated them with dignity and respect and the GP’s involved them in decisions about their treatment and care.

  • The practice is responsive to people’s needs. The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).
  • The practice is well-led. The practice had a clear vision and strategy to go beyond clinical outcomes and support patients in a holistic sense taking into account and addressing wider issues such as housing, education and other social issues and health determinants. 

All the population groups including older people; people with long term conditions; mothers, babies, children and young people; the working age populations and those recently retired; people in vulnerable circumstances and people experiencing poor mental health received care that was safe, effective, caring, responsive and well-led.

We saw several areas of outstanding practice including:

  • Improvements in care for patients who use services are made as a result of ongoing monitoring and clinical audit programme. Completed audit cycles had been undertaken and audits had been shared and extended to the GP practices within the network. The practice had also engaged with external consultants in relation to audits undertaken.

  • A systematic approach is taken to working with others in the health and social care economy to improve care outcomes and tackle inequalities. The practice participates in a Social Prescribing project jointly funded by funded by MEEBBB Health CIC and Tower Hamlets CCG in which they refer patients to wider support services, activities and programmes within the borough. The practice regularly engages with Public Health England and the community drug therapies team and provides weekly Benefits Advisor sessions for patients. The practice undertakes a number of health promotion activities both in house and out in the community to enable patients and members of the public to increase control over, and to improve, their health. The practice promoted healthy eating by holding workshops every six months at a local café and signposted patients to various services according to which health changes they want to make.

  • The practice had analysed the Joint Strategic Needs Assessment data and the priorities of the Clinical Commissioning Group (CCG) and local authority in the planning of its services to meet the needs of the local population. These included extended hours for appointments, diabetes clinics and substance misuse services. The practice opening hours were 8am – 8pm Monday to Friday and 9am -5pm on Saturdays.

  • There is a strong commitment to developing skills, competence and knowledge of staff through an in practice weekly mentoring an annual learning programme. The practice allocated protected time for clinicians each week for mentoring. Mentoring sessions included discussions on referrals, results and prescribing and provided an opportunity for personal development and career progression.

  • There are consistently high levels of constructive staff engagement and a high level of staff satisfaction. Staff are proud of the practice and contribute to the practice’s vision to go beyond clinical outcomes and support patients in a holistic way.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider should:

  • Carry out a fire risk assessment to ensure patients and staff are protected from the risks associated with fire in the premises.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 24 June 2014

During an inspection in response to concerns

At the time of the last inspection in December 2013, the provider was found to be compliant. Since that time, we received concerning information about the quality of care and treatment patients received and we were also notified that the provider had employed clinical staff who had failed to maintain up to date professional registration.

In response to the concerns, we carried out a responsive visit to the provider on Tuesday 24th June 2004. We spoke with ten patients using St Pauls Way Medical Centre, who told us they were satisfied with the quality of their care and treatment once they got to see a doctor. But most patients had at times experienced difficulties in obtaining an appointment. This included difficulties from getting through on the phone and obtaining an appointment when they wanted one, through to waits for the doctor once they arrived in reception. At the time of the last inspection in December 2013, patients commented that the surgery �could do with a better telephone booking system."

Most patients told us that they were spoken to in a respectful manner and were given the information they required, verbally and sometimes in writing, in order to make decisions about their care and treatment. However, a small number of patients did say that on occasion reception staff were �rude� or �abrupt�.

Staff at St Pauls Way Health Centre had received training to recognise possible abuse of children and they understood the local arrangements for safeguarding children and vulnerable adults. However, staff had not received important safeguarding vulnerable adults training. Arrangements for care and treatment including joint work with other professionals were effective.

Staff received appropriate training and support. We saw that when the provider became aware that a member of staff was working without professional registration they took immediate and appropriate action with the relevant professional regulator. Arrangements were now in place to prevent this type of breach from happening again. There were systems in place to listen to the views of patients and monitor the quality of the service, but shortfalls remained.

Inspection carried out on 20 December 2013

During a routine inspection

We spoke with seven people using St Pauls Way Medical Centre, who told us they were pleased with the quality of their care and treatment but some of them had at times experienced difficulties in booking appointments. One person using the service said, "I have been a patient here for 27 years. It has changed a lot for the better, waiting times are faster as I used to wait for ages. The staff are friendly and they are good." Another person told us, "I get enough time with the doctor and I feel I'm checked properly. The doctor is calm and confident, and the receptionists are good. My family telephoned this morning to get me an appointment" and a third person said, "the GP's are friendly and give a good service and the front of house service has really improved, but they could do with a better telephone booking system."

People told us they were spoken with in a respectful manner and were given the information they required in order to make decisions about their care and treatment.

Staff at St Pauls Way Health Centre had received training to recognise possible abuse and they understood the local arrangements for safeguarding children and vulnerable adults.

Staff recruitment was carried out safely.

There were systems in place to listen to the views of people and monitor the quality of the service.

People attending the practice were provided with information about how to make a complaint. There were procedures for recording and managing complaints, which were resolved wherever possible.