Background to this inspection
Updated
25 August 2020
Steppingstones Medical Practice is a long-established practice located in the Dudley area of the West Midlands. The surgery has good transport links and there is a pharmacy (independent of the practice) within the building. The provider is registered with CQC to deliver the Regulated Activities; diagnostic & screening procedures, treatment of disease, disorder or injury, maternity and midwifery services and family planning. Steppingstones Medical Practice is situated within the Dudley Clinical Commissioning Group (CCG) and provides services to approximately 8,482 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 three GP partners (two female, one male), a long term locum (male), an advanced clinical prescriber, an advanced nurse practitioner (ANP), a practice based pharmacist, two practice nurses and two health care assistants. The clinical team are supported by a practice manager, an assistant practice manager, a reception team leader and a team of administrative and reception staff covering a range of hours.
The practice is open between 8am and 6.30pm Monday to Friday with extended access appointments until 8pm on Monday, Tuesday and Thursday across the locality. Home visits are available for patients who are too ill to attend the practice for appointments.
There are a higher than average number of patients registered under the age of 18 years. The National General Practice Profile states that 72% of the practice population is from a white ethnic background with a further 28% of the population originating from black, Asian, mixed or other non-white ethnic groups. The practice area is one of high deprivation when compared with CCG and national averages. Information published by Public Health England, rates the level of deprivation within the practice population group as one, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.
The practice does not provide out of hours services to their own patients. When the practice is closed patients are directed to contact West Midlands Ambulance Service via 111.
The practice website can be viewed at: www.steppingstonesmedicalpractice.co.uk
Updated
25 August 2020
We carried out an announced comprehensive inspection at Steppingstones Medical Practice on 12 February 2019 as part of our inspection programme. We rated the practice as Good overall, however we found a breach of regulation and rated Well-led as Requires Improvement. You can read the full report by selecting the ‘all reports’ link for Steppingstones Medical Practice on our website at:
We are mindful of the impact of Covid-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the Covid-19 pandemic when considering what type of inspection was necessary and proportionate, this was therefore a desk-based review.
On 24 July we carried out a desk-based review to confirm that the practice had carried out its plan to meet the legal requirements in relation to the breach of regulation we identified at our previous inspection on 9 February 2019.
We found that improvements had been made and the provider was no longer in breach of the regulation and we have amended the rating for this practice accordingly. The practice is now rated as Good for the provision of well-led services. We previously rated the practice as Good for providing safe, effective, caring and responsive services.
During this desk-based review we looked at a range of documents submitted by the practice to demonstrate how they had met the requirement notice. The documents we looked at included those relating to:
- A revised structured clinical audit programme.
- Revised systems to identify and review vulnerable adults on their clinical system.
- A revised formal system in place for risk assessments as part of health and safety monitoring.
- A revised referral tracking system in place.
During this desk-based review we looked at the following question:
Are services well-led?
We found that this service was providing a well-led service in accordance with the relevant regulations.
- The practice had a programme of clinical audit in place to monitor and improve quality.
- The practice had an effective system to identify all known vulnerable adults and children on their clinical system.
- Health and safety arrangements had been strengthened and risk assessments put in place as part of risk management.
- The referral tracking system had been reviewed and a system in place to manage this proactively.
- The practice were continuing to engage with the patient participation group who had supported the practice with a number of campaigns.
The areas where the provider should make improvements are:
• Further explore ways to increase the uptake rates for cervical cancer screening.
• Explore ways to increase the identity of patients who also act as carers.
• Continue to review the patient satisfaction rates with telephone access.
Details of our findings and the evidence supporting our ratings are set out in the evidence table.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care