The Care Quality Commission
  • Doctor
  • GP practice

Tunstall Primary Care

Overall: Good read more about inspection ratings

Tunstall Primary Care Centre, Alexandra Park, Scotia Road, Stoke On Trent, Staffordshire, ST6 6BE 0300 123 0978

Provided and run by:
Tunstall Primary Care

All Inspections

19 May 2021

During an inspection looking at part of the service

We carried out an announced follow up inspection at Tunstall Primary Care on 19 May 2021. Overall, the practice is rated as Good.

Set out the ratings for each key question

  • Safe - Good
  • Effective -Good
  • Caring – Good
  • Responsive – Good
  • Well-led – Good

Following our previous inspection on 31 Jul 2019, we rated this practice as requires improvement overall and for key questions, safe and well led. We rated all of the population groups as good except for children families and young people which we rated as requires improvement.

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

Why we carried out this inspection/review

This inspection was a focused follow-up inspection with a site visit to follow up on:

  • Safe, Effective and Well Led key questions
  • Followed up on the breaches of regulations and best practice recommendations identified in the previous inspection
  • Ratings were carried forward from the previous inspection which included the caring, and responsive domains rated as good.

How we carried out the inspection/review

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
  • A short site visit to the branch and main practice locations.

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 have rated this practice as Good overall and good for all population groups.

We found that:

  • The practice had actioned and put measures in place for all the improvements areas identified in the previous inspection, including the breaches in regulations.
  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

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

  • Follow up on the fire risk assessments to ensure all actions are concluded and risks mitigated.
  • Continue to improve the uptake of childhood immunisations and to improve the uptake of cervical cancer screening.
  • Encourage attendance of patients with severe mental health to ensure there is a comprehensive, agreed care plan documented in the record, in the preceding 12 months.
  • Consider language support on the practice website.
  • Document the practice strategy.

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

31 Jul 2019

During an inspection looking at part of the service

We carried out an announced focused inspection at Tunstall Primary Care on 31 July 2019 as part of our inspection programme.

At this inspection, we followed up on breaches of a regulation identified at our previous inspection in June 2019.

We previously carried out an announced focused inspection at Tunstall Primary Care on 22 and 26 June 2018 as part of our inspection programme when we rated the practice as good overall and in all key questions except safe which we rated as requires improvement. We carried out an announced focused inspection on 18 June 2019 following our annual review of the information available to us. The practice was rated good overall and in all key questions except for safe and the population group for families, children and young people which we rated as requires improvement. A requirement notice in relation to safe care and treatment was served and we identified an additional four areas where the provider should make improvements. The full comprehensive reports for the June 2018 and June 2019 inspections can be found by selecting the ‘all reports’ link for Tunstall Primary Care Centre on our website at www.cqc.org.uk.

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 and in safe and well-led. The rating of good for the key questions regarding effective, caring and responsive care have been carried over from our previous inspection. The population group for families, children and young people continues to be rated as requires improvement.

We found that:

  • Clinical and most non-clinical staff had completed safeguarding training at a level appropriate to their role. There was a plan in place for non-clinical staff to complete outstanding training by the end of September 2019.
  • The recruitment policy had been updated to reflect all the recruitment requirements of Schedule 3 of the Health and Social Care Act 2008.
  • A process for providing salaried GPs with annual appraisals had been put in place and appraisals booked for September 2019.
  • Sharps’ containers had been replaced within three months after first use.
  • Up to date fire drill logs, and health and safety checks were available at the main practice.

However,

  • Systems for ensuring the practice had correctly identified and coded children at risk were ineffective due to lack of information sharing from external stakeholders. The provider had not followed the appropriate escalation process to raise and share these concerns.
  • A decision not to put a pregnancy prevention plan in place for a female patient of child bearing age, prescribed a medicine used for the treatment of epilepsy and bipolar disorder, had not been made in line with the Mental Capacity Act 2005.

The areas where the provider must make improvements are:

  • Ensure that care and treatment of patients is only provided with the consent of the relevant person.
  • 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 support non-clinical staff to complete safeguarding training at a level appropriate to their role.
  • Carry out their plan to provide salaried GPs with annual appraisals.

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

Dr Rosie Benneyworth BS BM BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care.

18 Jun 2019

During an inspection looking at part of the service

We carried out an announced focused inspection at Tunstall Primary Care on 18 June 2019 as part of our inspection programme.

At this inspection, we followed up on breaches of regulations identified at our previous inspection in June 2018.

We decided to undertake an inspection of this service following our annual review of the information available to us. This inspection looked at the following key questions:

  • Are services safe?
  • Are services effective?
  • Are services well-led?

We previously carried out an announced comprehensive inspection at Tunstall Primary Care on 22 and 26 June 2018 as part of our inspection programme. The practice was rated good overall and in all key questions except for safe which we rated as requires improvement. Requirement notices in relation to safe care and treatment and fit and proper persons employed were served. The full comprehensive report for the June 2018 inspection can be found by selecting the ‘all reports’ link for Tunstall Primary Care Centre on our website at www.cqc.org.uk.

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 in all key questions apart from safe which we rated as requires improvement. We rate all the population groups as good apart from families, children and young people which we rated as requires improvement.

We found that:

  • Policies for safeguarding vulnerable adults and maintenance of the cold chain had been updated to reflect national guidance.
  • Assessment of clinical staff immunity to potential healthcare acquired infections had been completed and risk assessments were in place where required.
  • There were systems in place for monitoring uncollected prescriptions and tracking prescription stationery throughout the practice.
  • Risk assessments had been completed to mitigate potential risks.
  • All of the recommended emergency medicines were available at the main and branch practice.
  • Patients prescribed a medicine used in the treatment of depression had been monitored in line with national guidance.
  • There had been an improvement in attaining the recruitment documents required and a system of monitoring that professional registrations were in date had been implemented.
  • Patients’ needs were assessed, and care and treatment were delivered in line with current legislation.
  • Staff were consistent and proactive in helping patients to live healthier lives.
  • The practice had a clear vision and strategy to provide high quality sustainable care which was supported through a culture of continuous learning.

However:

  • Systems for ensuring the practice had correctly identified children at risk were not effective.
  • Not all female patients of child bearing age, prescribed a medicine used for the treatment of epilepsy and bipolar disorder, had a pregnancy prevention plan in place.
  • The recruitment policy had not been updated to reflect all the recruitment requirements of Schedule 3 of the Health and Social Care Act 2008. Salaried GPs had not been provided with appraisals by the practice.
  • Sharps’ containers had not been replaced within three months after first use.
  • Up to date fire drill logs, and health and safety checks were not readily available at the main practice.

The area where the provider must make improvements are:

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

The areas where the provider should make improvements are:

  • Monitor that sharps containers are changed within recommended guidelines.
  • Continue to support non-clinical and clinical staff to complete safeguarding training at a level appropriate to their role.
  • Carry out their plan to provide salaried GPs with annual appraisals.
  • Liaise with the landlord of the main practice premises to provide reassurance that fire drills are logged, and health and safety checks are carried out and documented.

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

Dr Rosie Benneyworth BS BM BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care.

22/06/2018

During a routine inspection

This practice is rated as Good overall. (At the previous inspection on 2 December 2014 it was rated Good overall)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring?– Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Tunstall Primary Care on 22 June 2018 and returned on 26 June to review two staff records, that were not available on 22 June, as part of our inspection programme.

At this inspection we found:

  • The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. However, risk assessments were not always completed to mitigate safety risks to patients.
  • Systems to assess staff immunity to potential healthcare acquired infections were not effective.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines. However, patients prescribed the high-risk medicine, lithium, had not been monitored in line with national guidance.
  • Reception staff had not received training in identification of the rapidly deteriorating patient.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients found the appointment system had improved and reported that they were able to access care when they needed it.
  • There was a complaints system in place but information on how to complain was not readily available to patients within the practice.
  • Staff stated they felt respected, supported and valued and there was an open culture within the practice.
  • There were clear responsibilities and roles of accountability to support good governance and management. However, some policies did not reflect current guidance.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Ensure specified information is available regarding each person employed.
  • Ensure, where appropriate, persons employed are registered with the relevant professional body.

The areas where the provider should make improvements are:

  • Update policies to ensure they reflect current guidance. For example, policies for safeguarding vulnerable adults, recruitment and maintenance of the cold chain when providing vaccinations in patients’ homes.
  • Information regarding how to complain should be readily available for patients to access.
  • Introduce a system for tracking prescription pads throughout the practice.
  • Regularly monitor patients prescribed lithium in line with national guidance.
  • Provide reception staff with training to identify the rapidly deteriorating patient.

02 December 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We inspected this service on 2 December 2014 as part of our new comprehensive inspection programme.

The overall rating for this service is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. We found the practice provided good care to older people, people with long term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances and people experiencing poor mental health.

Our key findings were as follows:

  • Patients were kept safe because there were arrangements in place for staff to report and learn from key safety risks. The practice had a system in place for reporting, recording and monitoring significant events over time.
  • The appointment system was responsive to the needs of the patients. This ensured patients were able to access same day and emergency appointments.
  • There were systems in place to keep patients safe from the risk and spread of infection.
  • Evidence we reviewed demonstrated that patients were satisfied with how they were treated and that this was with compassion, dignity and respect. It also demonstrated that the GPs were good at listening to patients and gave them enough time.
  • Staff were all clear about their own roles and responsibilities, and felt valued, well supported and knew who to go to in the practice with any concerns.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

  • Complete a risk assessment to identify a list of emergency medicines that the practice needs to stock.
  • Provide staff who act as chaperones with appropriate training.
  • Ensure all staff receive personal development and support.
  • Record all discussions and actions to be taken from practice meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice