Archived: Moseley Medical Centre

We carried out an announced comprehensive inspection of Moseley Medical Centre on 23 July 2019.

The practice was last inspected in December 2018 and received a rating of Requires Improvement overall. We carried out a further follow up inspection on 23 July 2019 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations we identified on our previous inspection in December 2018.

The full comprehensive report and previous inspection reports can be found by selecting the ‘all reports’ link for Moseley Medical Centre on our website at www.cqc.org.uk.

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.

Following this inspection we have rated this practice as Good overall, however the practice was rated as Requires Improvement for providing well-led services. We also rated the practice as Requires Improvement for providing effective care to working age people.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm. The practices systems to keep people safe and safeguarded from abuse had been strengthened and staff we spoke with demonstrating good understanding of safeguarding principles.
• We noted a theme in positive feedback from staff during our inspection however feedback from patients was mixed. Results from the recently published national GP patient survey highlighted that patient satisfaction had declined in areas.
• Recruitment checks were carried out in accordance with regulations (including for agency staff and locums).
• We noted marked improvement in medicines management systems and practices. Systems for monitoring patients on high risk medicines had improved and performance for prescribing across certain areas such as for antibiotics was consistently positive.
• In some areas however we noted room for continued improvement, this was reflected in childhood immunisation uptake specifically for measles, mumps and rubella (MMR) and across various areas of cancer screening which were below average despite practice efforts to improve.
• Leaders demonstrated that they understood the challenges to quality, there was evidence of formal business and succession planning in place.
• The practice could not demonstrate that they had acted on appropriate and accurate information in all areas, whilst most records we observed were written in line with current guidance we identified two cases containing gaps in record keeping. During our inspection we found that some identifiable information was not stored in a secure manner. Although this was immediately rectified, our findings highlighted a need for the practice to strengthen their confidentiality practices.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

The areas where the provider should make improvements are:

• Ensure that record keeping is accurate, complete, stored and handled in a secure manner.
• Continue with efforts to improve uptake of childhood immunisations and cancer screening overall.
• Continue to explore further ways to improve patient satisfaction in response to feedback and below average satisfaction results.
• Explore further ways to identify and capture carers to ensure their care and support needs are met.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

This practice is rated as requires improvement overall.

(Previous rating February 2015 – Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

We carried out an announced comprehensive inspection at Moseley Medical Centre on 4 December 2018 as part of our inspection programme.

At this inspection we found:

• Feedback from patients gathered during our inspection was positive about the way staff treat people. Staff involved and treated patients with compassion, kindness, dignity and respect.
• There were gaps in the practices processes for managing risks, this including formally assessing and managing risk whilst awaiting the results of Disclosure and Barring Service (DBS) checks for chaperones, gaps in the practices recruitment systems as well as systems for checking staff immunisation against infection diseases.
• At the time of our inspection we found that the monitoring of patients on a specific high-risk medicine had lapsed.The practice did not always effectively utilise their patient record system and in areas coding did not take place. This contributed towards inaccurate information from the practices patient record system. At the time of our inspection we also found that records were not updated to reflect action taken where children failed to attend their hospital appointments, and the practice were not effectively coding these on their system.
• There was no evidence of regular historical practice meetings to support that learning from significant events and complaints was routinely discussed as a practice team.
• Staff worked together and with other health and social care professionals to deliver effective care and treatment.
• Staff stated they felt respected, supported and valued. Some staff we spoke with highlighted that they were unsure of who to go to with an infection control concern in the absence of the part-time infection control lead.
• The practice had a programme of quality improvement activity and there was evidence of monitoring of the outcomes of care and treatment that took place. However, performance for cancer screening was below local and national averages across various screening areas.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure care and treatment is provided in a safe way to patients.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

Where a service is rated as inadequate for one of the five key questions or one of the six population groups, it will be re-inspected no longer than six months after the report is published. If, after re-inspection, the service has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group or overall, we will place the service into special measures. Being placed into special measures represents a decision by CQC that a service has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice