Grove Medical Centre

We carried out an announced inspection at Grove Medical Centre. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring - Good

Responsive – Good

Well-led – Requires Improvement

We previously carried out an announced comprehensive inspection at Grove Medical Centre on 2 February 2020 as part of our inspection programme. The inspection in February 2020 was the first inspection following the merger of six services. Grove Medical Centre was registered as the main location for the other branch sites. The practice was rated as good overall.

The full report for the Grove Medical Centre following the merger can be found on our website at www.cqc.org.uk. The reports for the inspections of the former individual practices have been archived on our website.

Why we carried out this inspection

This inspection was a comprehensive inspection to review the Health and Beyond group of services. Following the last inspection two other practices had merged with Grove Medical Centre. This inspection was planned to follow up on whistleblowing concerns we received and concerns raised by patients relating to access.

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
• 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
• Site visits to the main location, Grove Medical Centre and four of its branch sites.

The inspections of the Health and Beyond Ltd. GP practices took place over a period of three months to provide time to follow up on the whistleblowing concerns received prior to and during the inspection process.

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
• information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall

We found that:

• The partnership provided care in a way that kept patients safe and protected them from avoidable harm. Staff were aware of systems and processes to follow if they had any concerns.
• The partnership learned from incidents, events and complaints and ensured learning was shared among the staff team.
• The partnership had made effective use of the multiple practice sites and had made adaptations to minimise the risks to patients and staff during COVID-19.
• We found the premises were well maintained, appeared clean and tidy and had appropriate infection prevention and control arrangements in place.
• Our clinical searches found patients medicines were safely managed. The partnership was supported by a pharmacy team who carried out regular audits to further support the safety of medicines prescribed.
• Patients received effective care and treatment that met their needs. Our review of clinical records found effective systems were in place for follow up and monitoring of patients with long term conditions.
• The partnership had a programme of improvement and development in place, which included restructuring of staff and systems for monitoring and improving the approach to patient care.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients reported difficulties accessing care and treatment in a timely way. The partnership and management team were aware of these concerns and plans were in place to address this. It was not evident however, that there was management oversight to monitor if progress was being made to improve access for their patients.
• It was not evident that leadership arrangements could demonstrate an open culture in which staff felt engaged and enabled to raise concerns.
• The partnership had high ambitions to develop a resilient and sustainable service following the merger of eight practices, despite significant challenges with COVID-19 and local pressures on the service.

Whilst we found no breaches of regulations, the provider should:

• Continue to develop centralised HR information so that it provides clear and accurate staff information for management and monitoring purposes.
• Continue to develop and improve the induction and recruitment processes and documentation.
• Provide evidence that staff vaccination and immunity for potential health care acquired infections are recorded or risk assessed for all staff.
• Improve the uptake of childhood immunisations and cervical and breast cancer screening.
• Continue to implement and monitor the action plan to improve access for patients and monitor the impact of the changes.
• Continue to implement and monitor the action planned to improve the staff working environment, communication arrangements with all staff groups and demonstrate an open culture in which staff felt engaged and enabled to raise concerns.

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