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Kings Road Medical Centre Good

Reports


Review carried out on 9 September 2021

During a monthly review of our data

We carried out a review of the data available to us about Kings Road Medical Centre on 9 September 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Kings Road Medical Centre, you can give feedback on this service.

Review carried out on 17 January 2020

During an annual regulatory review

We reviewed the information available to us about Kings Road Medical Centre on 17 January 2020. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 31 August 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kings Road Medical Centre on 20 September 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the September 2016 inspection can be found by selecting the ‘all reports’ link for Kings Road Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 31 August 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 20 September 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

  • The practice had made improvements in respect of the arrangements in place to manage fire safety.

  • Patients’ medical records were stored securely and confidentially.

  • Plans were in place to upgrade the branch practice.

  • Data from the Quality and Outcomes Framework showed patient outcomes had improved since our previous inspection.

  • Childhood immunisation rates had improved since our previous inspection.

  • The practice had drawn up an action plan to improve patient satisfaction with access.

The areas of practice where the provider needs to make further improvements are:

The provider should:

  • Continue to improve childhood immunisation rates to bring them in line with local and national averages.

  • Continue to monitor and act on feedback from patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 20 September 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

Following a comprehensive inspection of Kings Road Medical Centre on 17 December 2015 the practice was given an overall inadequate rating. The practice was placed in special measures and was found to be in breach of four regulations. Shortfalls identified included a lack of effective safety systems, ineffective complaints handling and inadequate governance arrangements.

We then carried out an announced comprehensive inspection on 20 September 2016 to consider if all regulatory breaches in the previous inspections had been addressed and to consider whether sufficient improvements had been made to bring the practice out of special measures. At this inspection we found improvements had been made. Overall the practice is rated as Requires Improvement.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

  • Risks to patients were generally assessed and well managed. However, some risks we identified at the branch surgery required action which included fire safety risks and the secure storage of patient records.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

  • Patients said they could make an appointment with a named GP in a reasonable time and there was continuity of care, with urgent appointments available the same day.

  • The main surgery had adequate facilities and was equipped to treat patients and meet their needs. However, the branch surgery was in urgent need of an upgrade. The premises were basic, in need of redecoration and furnishings required updating. The toilet facilities were not accessible for wheelchair users and there were no baby changing or breast feeding facilities. We were told by the partners that plans were in place to upgrade the branch practice.

  • There was a clear leadership structure and staff told us they felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

  • Ensure safe and proper storage of patient’s records to maintain information governance processes.

In addition the provider should:

  • Ensure the actions identified from the recent fire risk assessment carried out for the branch surgery are implemented and fire extinguisher servicing is brought up to date.

  • Implement the plan to upgrade the branch surgery.

  • Continue to monitor Quality and Outcomes Framework (QOF) exception reporting particularly in relation to diabetes indicators and bring in line with local and national averages.

  • Improve childhood immunisation uptake to bring in line with national averages.

  • Improve telephone access to both the main and branch surgeries.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Inspection carried out on 17 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kings Road Medical Centre on 17 December 2015. Overall the practice is rated as inadequate.

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

  • Patients were at risk of harm because systems and processes were not in place to keep them safe. For example, when reviewing the electronic document management system, we observed that one GP had 293 letters outstanding since 4 October 2015. There was no systematic process or support mechanism to ensure that clinical information was reviewed in a timely manner.

  • Staff were not clear about reporting incidents, near misses and concerns and there was no evidence of learning and communication with staff.

  • Patient outcomes were hard to identify as little or no reference was made to audits or quality improvement and there was no evidence that the practice was comparing its performance to others; either locally or nationally.

  • Patients were positive about their interactions with staff and said they were treated with compassion and dignity.

  • Appointment systems were not working well so patients did not receive timely care when they needed it.

  • The practice had no clear leadership structure, insufficient leadership capacity and limited formal governance arrangements.

The areas where the provider must make improvements are:

  • Introduce robust processes for reporting, recording, acting on and monitoring significant events, incidents and near misses.

  • Ensure recruitment arrangements include all necessary employment checks for all staff.

  • Ensure there are sufficient staff available to meet demand and keep patients safe.

  • Ensure there are systems that support staff with appraisals, supervision and training.

  • Put systems in place to ensure all clinicians are kept up to date with national guidance and guidelines.

  • Ensure there is a programme of quality improvement such as clinical audits including re-audits to drive improvements in outcomes for patients.

  • Implement formal governance arrangements including systems for assessing and monitoring risks and the quality of the service provision.

  • Provide staff with appropriate policies and guidance to carry out their roles in a safe and effective manner which are reflective of the requirements of the practice.

  • Clarify the leadership structure and ensure there is leadership capacity to deliver all improvements.

  • Ensure safe and proper storage of patients records to maintain information governance processes.

The areas where the provider should make improvement are:

  • Improve processes for making appointments.
  • Ensure the PPG is established to represent patients in the way services are delivered.
  • Ensure carers are identified and enabled to access support and information.

I am placing this practice in special measures. Where a practice is rated as inadequate for one of the five key questions or one of the six population groups and after re-inspection has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group, we place it into special measures.

Practices placed in special measures will be inspected again within six months. If insufficient improvements have been made so a rating of inadequate remains 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 varying the terms of their registration within six months if they do not improve.

The practice 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..

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

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice