You are here

Tooting South Medical Centre Requires improvement

Reports


Inspection carried out on 5 December 2019

During a routine inspection

We carried out an announced comprehensive inspection at Tooting South Medical Centre on 5 December 2019. We inspected the practice on 5 April 2016 and rated the practice as good overall, but as requires improvement for providing Caring services. The practice was rated as good for Caring following an announced desk-based follow up inspection on 2 November 2017.

We carried out an inspection of this service 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.

This inspection looked at the following key questions:

  • Are services safe?
  • Are services effective?
  • Are services caring?
  • Are services responsive?
  • Are services 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 requires improvement overall.

  • We have rated Safe as requires improvement because systems and processes to keep people safe had not been effectively implemented, including acting and monitoring on risk assessments.
  • We have rated Effective as Good because patients received effective care and treatment that met their needs.
  • We have rated Caring as requires improvement because the practice was statistically significantly below average for patient satisfaction with interactions with healthcare professionals. The practice had not taken effective steps to investigate the cause of the low satisfaction or to monitor whether the changes made to date had improved patients’ views of their care.
  • We have rated Responsive as requires improvement because the practice had received negative feedback from patients about access and having their needs met. The practice had taken action but had not put in place monitoring to ensure that these had resolved all of the issues.
  • We have rated Well-led as requires improvement because the practice had not put in place systems to ensure that systems and processes were operating as intended and had not established monitoring to ensure that actions taken had resulted in improvement or mitigated the intended risk.

We have rated all of the population groups as requires improvement for Responsive, because the issues affect all patients. A rating of requires improvement for this key question means that the population groups are all rated as requires improvement.

The areas where the provider must make improvements are:

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

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Continue to take action to improve uptake of childhood immunisations and cervical screening.
  • Improve the identification of carers to enable this group of patients to access the care and support they need.

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

Inspection carried out on 2 November 2017

During an inspection to make sure that the improvements required had been made

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Tooting South Medical Centre on 5 April 2016. The overall rating for the practice was good. No breaches of legal requirements were found, however the practice was rated as requires improvement for providing caring services. This was because data from the national GP patient survey showed patients rated the practice in line with national averages in most aspects of care. In some areas the practice was rated by patients as below average. The practice had not taken any action to address these areas.

We also found areas the practice should improve, including recall process for patients with long term conditions and poor mental health, reviewing action points from audits and recording verbal complaints and concerns.

The full comprehensive report and desk-based focussed inspection report can be found by selecting the ‘all reports’ link for Tooting South Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused desk-based inspection carried out on 2 November 2017 to review the improvements made in addressing and improving patient feedback. This report also covers additional areas of improvement made since our last inspection.

Overall the practice is rated as good. Specifically the practice was now found to be good for providing caring services.

Our key findings were as follows:

  • The practice had shown they had responded to patient feedback in the National GP Patient Survey and had gathered feedback via engaging with the Patient Participation Group (PPG), carrying out additional surveys and reviewing the NHS Friends and Family Test.

  • The practice had reviewed and improved their recall processes for patients with long term conditions and poor mental health. They also worked with a local mental health nurse to ensure patients with severe mental health conditions were reviewed.

  • The practice carried out audits and reviewed action points so that they lead to improved patient outcomes.

  • The practice kept a comprehensive log of verbal as well as written complaints.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection carried out on 5 April 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tooting South Medical Centre on 5 April 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

  • Risks to patients were assessed and well managed.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.

  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

  • 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.

  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

  • The practice should consider reviewing recall processes for patients with long term conditions and poor mental health where management criteria are lower than national averages.

  • The practice should consider reviewing action points in audits to ensure that they are more specific and lead to improved patient outcomes.

  • In view of patient feedback the practice should consider reviewing how patients are involved in their care and responding to patient feedback in the national GP patient survey.

  • The practice should consider retaining a log of complaints made in person rather as well as those received  in writing.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice