The Care Quality Commission
  • Doctor
  • GP practice

Toddington Medical Centre

Overall: Good read more about inspection ratings

Luton Road, Toddington, Dunstable, Bedfordshire, LU5 6DE (01525) 872222

Provided and run by:
Toddington Medical Centre

All Inspections

22 September 2021

During an inspection looking at part of the service

We carried out an announced inspection at Toddington Medical Centre on 22 September. Overall, the practice is rated as good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 13 January 2020, the practice was rated requires improvement overall and for the key questions are services safe, effective and well-led.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Toddington Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a focused inspection to follow up on:

  • The key questions inspected: are services safe, effective and well-led. The rating of good for are services caring and responsive was carried forward from the previous inspection.
  • Any breaches of regulations and areas we identified where the provider should make improvements identified in the previous inspection.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using video conferencing and telephone calls.
  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A short site visit.

Our findings

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 have rated this practice as good overall and for all population groups.

We rated the practice as good for providing safe services because:

  • Improvements had been made to the monitoring of patients who were prescribed high-risk medicines.
  • The practice had produced guidance for staff regarding the management of blood test results and records reviewed showed they were handled correctly.
  • Records were kept of the fridge temperatures to ensure vaccines were stored safely.
  • The practice had worked with a local occupational health clinic to ensure all staff were vaccinated in line with current PHE guidance.

We rated the practice as good for providing effective services because:

  • Improvements had been made to the system for medication reviews and the review of patients with a long-term condition.
  • A process was in place, supported by the administrative team, to recall patients for reviews.
  • The practice had achieved the WHO based national target of 95% uptake in four out of the five childhood immunisation indicators.

We rated the practice as good for providing well-led services because:

  • Governance structures had been strengthened and there were clear responsibilities, roles and systems of accountability to support good governance and management.
  • Business meetings were used to identify challenges for the practice and make plans to address them.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

13 Jan 2020

During a routine inspection

The service is rated as requires improvement overall.

We carried out a comprehensive announced inspection of this service on 20 January 2020 following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a significant change to the quality of care provided since the last inspection.

Our judgement of the quality of care at this service is based 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.

The practice is rated as requires improvement overall.

The practice was rated as requires improvement for providing safe care because:

  • Patients who were prescribed medicines that required additional monitoring did not consistently have the appropriate blood testing conducted. Shortly following the inspection, we received evidence that the patients affected had been contacted and a protocol had been put in place to prevent recurrence.
  • There were gaps in the monitoring of fridge temperatures to support the safe storage of vaccinations.
  • The practice did not hold a complete record of staff immunisation history, however this was in the process of being completed.
  • There was a comprehensive system of risk assessment.
  • There were adequate systems in place to manage infection prevention and control.
  • Staff and patients were safeguarded from abuse and there were systems in place to escalate concerns.

The practice was rated as requires improvement for providing effective care because:

  • The system to review medicines and care plans was ineffective, particularly for patients with long-term conditions such as diabetes or cardiovascular disease. Shortly following the inspection, the practice sent evidence that the process for reviewing patients with long term conditions had been audited and revised to ensure patients received appropriate follow up. All patients who had been affected were contacted and invited for a consultation.
  • The recall system was lacking and follow up appointments were not consistently conducted. Shortly following the inspection, we received evidence that these processes had been reviewed and strengthened.
  • Staff had the skills and training to undertake their roles. However, there was not a system in place to assess nurse competency.

The practice was rated as good for providing caring services because:

  • The practice had identified over 2% of their practice population as carers.
  • Patients told us that staff treated them with kindness and compassion.

The practice was rated as good for providing responsive services because:

  • The GP patient survey results were in line with local and national averages.
  • Some patients told us there could sometimes be difficulty accessing the practice via the telephone when it first opens. The practice was aware of this and had increased their telephone capacity.
  • Patients told us they had enough time in their appointments and did not feel rushed.
  • Complaints were dealt with in a timely manner and the practice used them to improve care.

The practice was rated as requires improvement for providing well-led services:

  • There was limited oversight of patients who required review of their condition or medicines. However, shortly following the inspection, we received evidence that these processes had been reviewed.
  • Staff told us that leaders were approachable and would respond to concerns raised.
  • The practice acted on significant events, safety alerts and complaints to make improvements.

The areas where the provider must make improvements as they are a breach of regulation are:

  • Ensure care and treatment is provided in a safe way to patients.

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

Dr Rosie Benneyworth BS BM BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

9 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Toddington Medical Centre on 2 December 2015. Overall the practice is rated as good.

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

  • Risks to patients were assessed and well managed.
  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care. Urgent appointments available the same day and telephone consultations were offered.
  • Access to the service was monitored to ensure it met the needs of patients.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • Emergency medicines and oxygen were available.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice