The Care Quality Commission
  • Doctor
  • GP practice

The Cottons Medical Centre

Overall: Good read more about inspection ratings

The Cottons, Meadow Lane, Raunds, Wellingborough, Northamptonshire, NN9 6UA (01933) 623327

Provided and run by:
The Cottons Medical Centre

All Inspections

28 June 2023

During a routine inspection

We carried out an announced focused inspection at The Cottons Medical Centre on 28 June 2023. Overall, the practice is rated as good.

Safe - good

Effective - good

Responsive - requires improvement

Well-led - good

Following our previous inspection on 19 May 2022, the practice was rated good overall and for all key questions except for providing safe services they were rated as requires improvement.

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

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from a previous inspection.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • 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 found that:

  • The practice had clear systems, practices and processes to keep people safe and safeguarded from abuse.
  • Improvements had been made to the systems and processes in place to effectively monitor the safe use of medicines.
  • The system for managing safety alerts was embedded in the practice. We noted appropriate actions had been taken for safety alerts received.
  • Some patients with long-term conditions were overdue a review of their medicines and conditions. The practice had put measures in place to address this.
  • There was a programme of quality improvement in place and staff had received training to carry out their roles.
  • Actions had been taken to improve access to the practice, including appointment booking. However, it was too soon to assess the impact of these improvements.
  • Feedback from staff was generally positive. Staff reported they felt supported by the GPs and practice manager.

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

  • Follow up patients who do not respond to invitations for a review of their medicines.
  • Continue with work to carry out medicine and long-term condition reviews in line with current guidelines.
  • Continue to promote the uptake of cervical screening.
  • Continue to take measures to improve access to the service.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care

17 and 19 May 2022

During an inspection looking at part of the service

We carried out an announced focused inspection of The Cottons Medical Centre on 17 and 19 May 2022.

Safe – Requires Improvement

Why we carried out this inspection

The practice was inspected on 3 December 2020 and whilst the practice was rated Good overall, it was rated as Requires Improvement for providing safe services. During this inspection we identified a breach of Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment. We issued a requirement notice in relation to the breach and the practice provided an action plan in response to this.

We carried out an announced focused inspection of the practice on 17 and 19 May 2022 to confirm that the practice had carried out their plan to meet the legal requirements regarding the breaches in regulation set out in the requirement notice we issued to the provider.

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
  • Requesting and reviewing evidence and information from the service

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 continue to rate this practice as Requires Improvement for providing safe services, the practices overall rating of Good remains.

We found that:

  • In some areas we were assured that policies and procedures were effectively embedded, this was reflected in the practices system for summarising new patient notes.
  • However, in other areas we noted a lack of effective clinical oversight. For instance there were gaps across some of the practices systems and processes to effectively monitor the safe use of medicines.
  • The practice did not always operate an effective system for managing medicines safety alerts.

We found a breach of regulations. The provider must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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

03 December 2020

During a routine inspection

We carried out an announced comprehensive inspection at The Cottons Medical Centre on 2 and 3 December 2020 as the practice had previously been rated inadequate and was put in special measures in February 2020.

We are mindful of the impact of the 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 is why there was a delay in re-inspecting this service.

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 requires improvement in safe. We have rated this practice as good for all population groups except the population group people with long-term conditions which is rated as requires improvement.

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The Patient Participation Group was positive about their relationship with the practice. They felt supported, appreciated and valued, and commented positively on the practice’s response during the pandemic.
  • The practice now had a comprehensive system in place to learn from significant events
  • The practice had a system to manage and learn from complaints.
  • The practice had a plan to be and made progress in summarising patient records including recruiting and training extra staff to help with this.
  • The practice had carried out quality audits over the last 12 months to improve outcomes for patients.

The areas where the provider must make improvements are:

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

In addition, the provider should:

  • Continue to monitor the summarisation of records.
  • Continue to review historic MHRA alerts to ensure that any actions needing to be taken are completed.

I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.

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

4 December 2019

During a routine inspection

We carried out an announced comprehensive inspection at The Cottons Medical Centre on 4 December 2019. This was due to the length of time since the last inspection.

Following our review of the information available to us, including information provided by the practice, we focussed our inspection on the following key questions:-

Are they safe?

Are they effective

Are they caring

Are they responsive to people’s needs?

Are they well-led?

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 Inadequate overall.

  • The practice had a leadership structure but some of the governance arrangements in place were not effective.
  • Patients were at risk of harm because some systems and processes in place were not effective to keep them safe.
  • Risks to patients were assessed but the systems and processes to address these risks were not implemented well enough to ensure patients were kept safe.

We rated the practice as Inadequate for providing a Safe service. We found:-

  • The practice did not have an effective system in place to safeguard service users from abuse and improper treatment.
  • Patients were at risk of harm because some systems and processes in place were not effective to keep them safe.
  • The practice had systems for the appropriate and safe use of medicines, including medicines optimisation.

We rated the key questions of Effective, Caring and Responsive at Good overall along with the population groups.

We rated the practice as Inadequate for providing a well-led service . We found:-

  • We found a lack of leadership and governance relating to the overall management of the service. The practice was unable to demonstrate strong leadership in respect of safety.
  • The arrangements in place for managing risks were not effective.
  • Meeting minutes did not contain enough detail to provide information to staff.
  • The practice had a programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.
  • The practice organised and delivered services to meet patients’ needs.
  • The practice had a number of policies and procedures to govern activity.

The areas where the provider must make improvements are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Ensure patients are protected from abuse and improper treatment.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

More detail can be found in the requirement and enforcement section at the end of the report.

The areas where the provider should make improvements are:

  • Review the business continuity plan to ensure identified risks are mitigated.
  • Monitor exception reporting to ensure current system is effective.
  • Improve the recording of significant events and complaints to include learning and actions taken.
  • Take action to improve patient satisfaction.
  • Ensure meeting minutes include all areas of practice governance and allow opportunities for learning.

I am placing this service in special measures. Services 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 service 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 remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

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

24 October 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We visited The Cottons Medical Centre on the 24 October 2014 and carried out a comprehensive inspection.

The overall rating for this practice is good.

Our key findings were as follows:

  • Patients reported being treated with kindness, dignity and respect and GPs and nurses spent time listening to and dealing with patients’ medical problems.
  • There were systems in place to provide a safe, effective, caring and well run service.
  • The practice had taken steps to engage with patients to address access issues and improve services.
  • There was a good understanding of the needs of the practice population and services were offered to meet these.

There was one area of outstanding practice:

  • One GP had developed their own patient information leaflet to help patients attending the practice to understand their cholesterol levels and help them to reduce and control these.

However, there were some areas of practice where the  practice could make improvements.

The  practice should:

  • Identify a programme of audit and a date to re-audit and complete the audit cycle to determine the effectiveness of any actions or changes made.
  • Develop a risk log to evidence that a process is in place for identifying, discussing and mitigating risks.
  • Ensure that any staff who are to act as a chaperone at any time receive the appropriate chaperone training.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice