The Care Quality Commission
  • Doctor
  • GP practice

East Lynne Medical Centre

Overall: Good read more about inspection ratings

3-5 Wellesley Road, Clacton On Sea, Essex, CO15 3PP (01255) 220010

Provided and run by:
East Lynne Medical Centre

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about East Lynne Medical Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about East Lynne Medical Centre, you can give feedback on this service.

28 September 2021

During a routine inspection

We carried out an announced inspection at East Lynne Medical Centre on 28 September 2021. Overall, the practice is rated as good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Outstanding

Following our previous inspection on 15 October 2019, the practice was rated requires improvement overall. Specifically, they were rated requires improvement for effective, caring, and responsive services and rated good for safe and well-led services. We issued a requirement notice at this inspection.

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

Why we carried out this inspection

This was a comprehensive inspection to follow up on the breaches of the regulations identified at the last practice, other areas where the practice was told should be improved, and to re-rate the practice.

How we carried out the inspection

Throughout the pandemic the 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 the 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.

At this inspection we have rated this practice as good overall and good for all the population groups. Specifically, they were rated good for safe, effective, caring, and responsive services and rated outstanding for well-led services.

We found that:

  • The breaches found in the previous inspection had been complied with and actioned. The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • We saw risk assessments were undertaken and actions taken when issues were found.
  • Patients received effective care and treatment that met their needs. The patient records we reviewed showed care pathways and protocols were well managed and followed.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care. This was explained to us when we spoke with patients when we visited the practice.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
  • The practice leaders had an inspiring shared purpose to strive, deliver and motivate staff to succeed.
  • There were high levels of staff satisfaction. Staff were proud to work at the practice and spoke highly of the culture.
  • The leadership at the practice were committed to continuous improvement and staff members took responsibility for delivering change.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care. This was seen in the numerous improvements undertaken since the two GP partners took over the practice 18 months ago.

We have rated well-led as outstanding because;

  • The partners had pro-actively sought care and treatment opportunities to improve the quality of services delivered to their patients. This work was completed entirely during the COVID 19 pandemic access restrictions, to benefit their patients.
  • The provider recognised that the restrictions placed on practices and the public as a result of the Covid 19 pandemic was likely to affect patient care. They introduced several initiatives in order to maintain access to good quality, safe and effective care and treatment whilst reducing the risk of COVID 19 transmission. These were:
    • Equipment purchased to improve diagnostic testing for patients during home visits for example a portable ECG machine and a blood centrifuge machine to stabilise blood samples and eliminate the need for those people vulnerable to Covid 19 pandemic health concerns, and older people needing to make a practice visit to receive these tests.

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

  • Continue to improve patient uptake for cervical screening and child immunisation programmes.

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

During an inspection looking at part of the service

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 focused on the following key questions:

Are services at this location effective?

Are services at this location caring?

Are services at this location responsive?

Are services at this location well-led?

At the last inspection on 31 January 2017 we rated the practice as good overall for services.

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 requires improvement overall and for all the population groups.

We rated the practice as requires improvement for providing effective services because:

  • We found patient’s care and treatment needed to be improved in respect of long term condition management, mental health, childhood immunisations, and cancer care.
  • Exception reporting was high for a number of quality indicators, and a satisfactory reason for this has not been provided by the practice, so we were not assured that patients had received appropriate care and treatment.

We rated the practice as requires improvement for providing caring services because:

  • Patient satisfaction was lower than local and national practices for caring indicators.

We rated the practice as requires improvement for providing responsive services because:

  • Although there were a few areas of patient satisfaction that had improved, there were still many areas that were lower in comparison with local and national practices.

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

  • Staff members were encouraged to be involved in any development or change and improvements at the practice.
  • Leadership at the practice promoted holistic person-centred care.
  • Patients told us they were involved in decisions about their care.

The areas where the provider must make improvements are:

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

The areas where the provider should make improvements are:

  • Continue to improve patient satisfaction where levels are still low.

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

26 September 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We undertook a comprehensive inspection of East Lynne Medical Centre on 28 October 2015. The practice was rated inadequate overall.

We undertook a comprehensive follow-up inspection of East Lynne Medical Centre on 31 January 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection. The practice was rated as good overall with requires improvement for responsive services.

The full comprehensive and follow-up reports following the inspections can be found by selecting the ‘all reports’ link for East Lynne Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused follow-up inspection carried out on 26 September 2017 to check that the practice had made sufficient improvements as identified in the last inspection on 31 January 2017. We also needed to monitor and consider anonymous concerns and complaints we had received since the previous inspection on 31 January 2017.

Our key findings were as follows:

  • Work had been carried out to understand and improve the appointment making process at the practice. However, patient satisfaction in the July 2017 GP national survey remained extremely low compared to local and national practices.
  • There was an action plan to review exception reporting within the Quality and Outcome Framework (QOF) work.
  • Nursing staff had been given more responsibilities to carry out long-term condition management reviews.
  • A new process monitored concerns and complaints raised verbally.
  • Audits and practice patient surveys were used to monitor patient feedback.
  • A protocol had been implemented to review vulnerable children and adults that had not attended their hospital or follow-up appointments.
  • Patients said they were concerned by the lack of GPs working at the practice. Patients told us that when a nurse or GP asked them to book a follow-up appointment they found none available.
  • Patients also said they were also concerned about no continuity of care provided by GPs.
  • Patients accessing the practice by telephone told us on the day of inspection it was difficult.

Actions the practice must take to improve:

  • Establish systems or processes to enable the registered person to seek and act on feedback from patients and staff on the services provided in the carrying on of the regulated activities, to continually evaluate and improve services.

Actions the practice should take to improve:

  • Improve exception reporting rates.

Consequently, the practice is still rated as requires improvement for providing responsive services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

31 January 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at East Lynne Medical Centre on 31 January 2017. This inspection was a follow up to our previous comprehensive inspection at the practice on 28 October 2015 where breaches of regulation had been identified. The practice was formally known as Dr S Sherwood and Partners and the management of the practice had changed in August 2016. The overall rating of the practice following the 28 October 2015 inspection was inadequate and the practice was placed into special measures for a period of six months.

At our inspection on 31 January 2017 we found that the practice had improved. The ratings for the practice have been updated to reflect our recent findings. The practice is rated as good for providing safe, effective, caring and well led services. It is rated as requires improvement for providing responsive services.

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • The practice had implemented new systems and processes to ensure that risks to patients were assessed and well managed.
  • Extensive work had been undertaken to ensure that there was an effective system in place to support patients who were prescribed medicines that required monitoring. Furthermore, a protocol had been developed to ensure that reviews of safety updates from the Medicines and Healthcare Products Regulatory Agency (MHRA) were undertaken.
  • 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.
  • Formal governance arrangements had been instigated to monitor the quality of the service provision.
  • Feedback from patients about their care was generally positive. Patients said they were treated with compassion, dignity and respect, and that clinical staff took their concerns seriously.
  • However, we received negative feedback relating to the appointments system used at the practice. The practice recognised that there was progress to be made in this area, and were working with the wider health community to address the issue.
  • Information about services and how to complain was available and easy to understand. However, not all verbal complaints were reported to the management team. This meant that it was difficult to identify trends in verbal complaints and make improvements where required.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Policies and procedures had been reviewed and updated to reflect the requirements of the practice.
  • There was a clear leadership structure in place and staff felt well supported by the GP partners and management team. Staff were encouraged to provide feedback at monthly whole team meetings and had regular appraisals.

The areas where the provider should make improvements are:

  • Improve processes for making appointments.
  • Review the way exception reporting is used.
  • Record, monitor and action concerns raised in verbal complaints.
  • Continue to monitor patient feedback.
  • Implement a protocol for reviewing children who do not attend hospital appointments.

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

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

28 October 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Sherwood and Partners practice on 28 October 2015. Overall the practice is rated as inadequate.

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

  • GP staffing levels were insufficient to meet the needs of patients although the practice had been actively recruiting for some time without success.

  • Patients were at risk of harm because some systems and processes were not in place to keep them safe. This included the system used for monitoring patients on high-risk medicines and action not taken as a result of an infection control audit.

  • Staff had received training in safeguarding children and vulnerable adults and a safeguarding lead had been appointed.

  • Staff spoken with felt discouraged about reporting incidents, near misses and concerns and there was a lack of a robust system to evidence learning being shared with staff. However there was a positive reporting culture.

  • The learning from complaints was not being routinely shared with staff. The practice carried out clinical audits but these had not been repeated to assess whether improvements had been maintained.

  • Patients were positive about their interactions with staff and said they were treated with compassion and dignity.

  • Chaperones were readily available and had been appropriately trained for the role.

  • Urgent appointments were usually available on the day they were requested. However, patients told us the appointment system needed improving as they felt they did not always receive timely care when they needed it.

  • The practice had a number of policies and procedures to govern activity, but some were overdue a review.

  • The practice had sought feedback from patients and had an active patient participation group. There was no system in place to seek feedback from staff. Not all staff had received an appraisal.

  • The practice had a leadership structure, however some staff felt they were not listened to and there were limited formal governance arrangements.

  • Multidisciplinary team meetings were taking place but were not being recorded to reflect the care and treatment decisions made about patients.

The areas where the provider must make improvements are:

  • Ensure that the learning from the analysis of significant events, notifiable safety incidents and complaints is shared with staff and that there is an audit trail to reflect improvements have been actioned.

  • Put systems in place to ensure all clinicians act on medicines alerts and ensure that patients on high risk medicines are reviewed in line with published guidance.

  • Ensure that the issuing of prescription stationery is recorded to track how they are used.

  • Implement formal governance arrangements including systems for assessing and monitoring risks and the quality of the service provision.

  • Provide staff with appropriate policies and guidance to carry out their roles which are reflective of the requirements of the practice. Provide staff with suitable appraisal.

  • Clarify the leadership structure and ensure there is leadership capacity to deliver all improvements. Ensure that all staff area aware of issues affecting the practice so that they can contribute ideas for improvement.

The areas where the provider should make improvement are:

  • Respond to patient feedback in relation to the appointment system.
  • Improve audit cycle to ensure improvements identified are implemented and maintained.
  • Record the multidisciplinary meetings to reflect the decisions, and care and treatment agreed for patients.

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 so a rating of inadequate remains 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.

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

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice