The Care Quality Commission
  • Doctor
  • GP practice

Lister Medical Centre

Overall: Requires improvement read more about inspection ratings

Abercrombie Way, Harlow, CM18 6YJ (01279) 639791

Provided and run by:
Lister Medical Centre

Important: This service was previously registered at a different address - see old profile

All Inspections

12 January 2023

During a routine inspection

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:

We rated the practice requires improvement for providing safe services because:

  • The practice did not always provide care in a way that kept patients safe and protected them from avoidable harm.
  • Systems, practice and processes to keep people safe and safeguarded from abuse required strengthening.
  • The practice had recruited to a number of posts to provide an increase in, and the types of, appointments available to meet patient’s needs, but staffing levels remained below local and national averages in clinical workforce levels.
  • There were appropriate standards of infection control measures and safety systems.
  • The practice learned and made improvements when things went wrong.

We rated the practice requires improvement for effective services because:

  • Patients did not always receive effective care and treatment that met their needs.
  • Leaders and staff working at the practice had a commitment to improve.
  • Patients could not always access care and treatment in a timely way.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
  • Not all patients with long-term conditions had been offered a structured annual review.
  • Uptake rates for the cervical screening programme remained below the national target.
  • The practice had not met the recommended standards for all childhood immunisations.
  • There were improvements in system and processes to monitor staff training. However, there were still gaps in the practice’s mandatory training schedule.

We rated the practice requires improvement for caring services because:

  • We observed staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • National GP patient survey results demonstrated a decline in patient satisfaction and were below national and local targets.

We rated the practice requires improvement for responsive services because:

  • National GP patient survey results for accessing services had continued to remain below local and national targets.
  • The practice adjusted how it delivered services to meet the needs of patients.
  • Complaints were not always managed effectively.

We rated the practice requires improvement for well-led services because:

  • Systems to manage feedback when people were affected by things that went wrong were not always effective.

We found the following breach of regulations. The provider must:

  • 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.

In addition, the provider should:

  • Continue to embed the practice medicine management plan to ensure safe prescribing and drug monitoring.
  • Improve the system to implement actions and learning identified from significant events.
  • Take steps to develop and implement actions identified through quality improvement initiatives.

We also found that:

  • The practice had taken action following the previous inspection in May 2022 to make improvements in systems and processes to keep people safe.
  • The practice had made improvements in the recruitment and upskilling of staff to increase its capacity to deal with patients.
  • There was a programme of targeted quality improvement in place. Leaders had demonstrated improvements in the capacity and skills to deliver high quality sustainable care.
  • Overall there had been improvements in governance processes and systems.

I am taking this service out of special measures. This recognises the overall 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 Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

06 mAY 2022

During a routine inspection

We carried out an announced inspection at Lister Medical Centre on 6 May 2022. Overall, the practice is rated as Inadequate.

We rated each key question as follows:

Safe - Inadequate

Effective – Inadequate

Caring – Good

Responsive – Inadequate

Well-led – Inadequate

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

Why we carried out this inspection

This inspection was a comprehensive inspection and the first inspection under the new provider registration.

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
  • 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 have rated this practice as Inadequate overall

We found that:

  • The practice systems and processes to keep people safe were not effective.
  • Not all staff were trained to the appropriate level of safeguarding training.
  • Some staff did not have appropriate recruitment checks to ensure their suitability for the role.
  • A fire risk assessment was overdue.
  • Health and safety risk assessments had not been completed when risk had been identified.
  • An Infection Prevention and Control (IPC) lead was not in place and staff had not acted on identified significant IPC issues.
  • Staff were not equipped to respond to medical emergencies.
  • There were not enough staff to provide the number and types of appointments needed and prevent staff from working excessive hours.
  • There were delays in the management of referrals and test results.
  • Medicines were not stored safely and securely.
  • The process for the management of high-risk medicines was not safe.
  • Medicines reviews were not always completed.
  • The system to receive, review and take appropriate action on Medicines and Healthcare products Regulatory Authority (MHRA) was not effective.
  • Learning from incidents was not routinely shared with all staff.
  • Patients’ treatment was not always regularly reviewed and updated.
  • There were delays in the management of referrals and tasks.
  • There were no effective systems for identifying and monitoring vulnerable patients and long-term conditions patients had not been proactively monitored throughout the pandemic;
  • Childhood immunisations and cervical cancer screening indicators were below national averages.
  • There was no programme of targeted quality improvement in place.
  • The practice had failed to use data and information on its clinical record system to drive improvements or monitor care.
  • Competency checks had not been completed for all staff.
  • The practice did not organise and deliver services to meet patients’ needs.
  • Patients were not able to access appointments and treatment in a timely way.
  • Complaints were not managed effectively.
  • Leaders did not demonstrate they had capacity and skills to deliver high quality sustainable care.
  • There was poor governance of the entire service and little or no assurance of processes or systems that were embedded in the organisation.

We found breaches of regulations. The provider must:

  • 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.
  • Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.

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 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