• Doctor
  • GP practice

Archived: Abbey Medical Centre

Overall: Inadequate read more about inspection ratings

1 Harpour Road, Barking, Essex, IG11 8RJ 0844 477 8598

Provided and run by:
Abbey Medical Centre

Latest inspection summary

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Background to this inspection

Updated 5 November 2015

Dr MF Haq's Practice also known as Abbey Medical Centre is located in Barking, East London. The practice holds a Personal Medical Services (PMS) contract with NHS England. This is a locally agreed alternative to the standard GMS contract used when services are agreed locally with a practice which may include additional services beyond the standard contract. The practice has opted out of providing out-of-hours services to their own patients.

The practice has a patient list of approximately 6,500. Approximately 6% of patients are aged 65 or older and approximately 20% are under 18 years old. Forty seven percent have a long standing health condition and 24% have carer responsibilities.

Practice opening hours are 8:30am to 8pm Monday and Wednesday, 8.30am to 7pm Tuesday, 8:30am to 12pm Thursday and Friday 8:30am to 6pm. Outside these times, telephone cover is provided by an out of hours provider. In addition, to pre-bookable appointments, urgent appointments are also available for people that needed them.

The services provided include child health care, ante and post-natal care, immunisations, sexual health and contraception advice and management of long term conditions clinics. The staff team comprises one senior GP (male), two salaried GPs (one female, one male), one long term GP locum (male), two female practice nurses (including an advanced nurse practitioner), practice manager, practice development manager and a range of administrative staff.

The senior GP and one of the salaried GPs are joint contract holders of the PMS contract the practice holds with NHS England.

The practice is registered with the Care Quality Commission to carry on the regulated activities of Treatment of disease, disorder or injury, Diagnostic and screening procedures, maternity and midwifery procedures, family planning services and surgical procedures.

The practice operates a branch location called Vicarage Field Health Centre. We did not visit this site as part of this inspection. Clinical and non clinical staff work across both sites.

We inspected Dr MF Haq's Practice in September 2014 using our old methodology and found it to be compliant with the regulations at that time. The outcomes we looked at under the old methodology were as follows: respecting and involving people, care and welfare, safeguarding, supporting workers and assessing quality of service provision.

Overall inspection

Inadequate

Updated 5 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr MF Haq's Practice on 12 May 2015. Overall the practice is rated as inadequate.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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 we identified concerns with the arrangements for managing vaccines.
  • Staff were not clear about reporting incidents, near misses and concerns; and there was limited evidence of learning and communication with staff.
  • Patients were positive about their interactions with staff and said they were treated with compassion and dignity.
  • Formal governance arrangements were limited and we noted confusion regarding roles and responsibilities.
  • There was evidence of division and a lack of communication between clinical and non-clinical staff which hindered progress on improving patient outcomes.

The areas where the provider must make improvements are:

  • Introduce protocols to ensure that vaccines are safely managed and stored; and that staff are aware of their responsibilities.
  • Undertake a risk assessment of the practice’s decision to carry a limited range of emergency drugs; and introduce a system of checking expiry dates of emergency drugs.
  • Take action to address identified concerns with infection prevention and control practice (such as an absence of annual infection prevention and control audits; a lack of cleaning schedules for ear syringe, nebuliser and spirometer equipment; and worn waiting area seating which posed a cross infection risk).
  • Ensure there are systems in place so that learning from significant events is communicated to support improvement.
  • Ensure clinical audits are undertaken in the practice, including completed clinical audit or quality improvement cycles.
  • Introduce a written protocol for instances where GPs are on annual leave (or otherwise unavailable) for dealing with patient blood test results.
  • Ensure that recruitment arrangements include all necessary pre-employment checks.
  • Ensure that appropriately signed Patient Group Directions (PGDs) are on file for practice nurses where this is required.

In addition the provider should:

  • Undertake a risk assessment of its decision not to undertake portable appliance testing of non clinical electrical equipment.
  • Introduce a safeguarding vulnerable adult’s policy.
  • Review the practice patient confidentiality systems and procedures.
  • Ensure that all non clinical staff receive annual appraisals.

I am placing this practice in special measures. Practices placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate 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 to 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 by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

People with long term conditions

Inadequate

Updated 5 November 2015

The provider was rated as inadequate for providing safe and well led services; and rated as requires improvement for providing effective and caring services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The practice is rated as inadequate for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Inadequate

Updated 5 November 2015

The provider was rated as inadequate for providing safe and well led services; and rated as requires improvement for providing effective and caring services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The practice is rated as inadequate for the care of families, children and young people. There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were comparable to locality averages for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies.

Older people

Inadequate

Updated 5 November 2015

The provider was rated as inadequate for providing safe and well led services; and rated as requires improvement for providing effective and caring services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The practice is rated as inadequate for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Working age people (including those recently retired and students)

Inadequate

Updated 5 November 2015

The provider was rated as inadequate for providing safe and well led services; and rated as requires improvement for providing effective and caring services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The practice is rated as inadequate for the care of working-age people (including those recently retired and students). The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

People experiencing poor mental health (including people with dementia)

Inadequate

Updated 5 November 2015

The provider was rated as inadequate for providing safe and well led services; and rated as requires improvement for providing effective and caring services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The practice is rated as inadequate for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

People whose circumstances may make them vulnerable

Inadequate

Updated 5 November 2015

The provider was rated as inadequate for providing safe and well led services; and rated as requires improvement for providing effective and caring services. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The practice is rated as inadequate for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had told vulnerable patients about how to access various support groups and voluntary organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours. However, the practice did not have a written policy for safeguarding vulnerable adults.