Background to this inspection
Updated
16 December 2020
The Village Medical Centre provides a range of primary medical services to the residents of Bedford from its location at Kingswood Way, Great Denham, Bedford, Bedfordshire, MK40 4GH.
The practice population is pre-dominantly white British. They have a higher than average number of patients aged under 44 years of age and a lower than average number aged over 65 years. Information published by Public Health England, rates the level of deprivation within the practice population group as nine, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is 83 years compared to the national average of 79 years. Female life expectancy is 87.5 years compared to the national average of 83 years.
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury.
The Village Medical Centre is situated within the Bedfordshire Clinical Commissioning Group (CCG) and provides services to approximately 8,700 patients under the terms of an Alternative Provider Medical Services (APMS) contract, a locally agreed contract with NHS England and GP Practices.
The registered provider is Innovations Healthcare Solutions, a company that provides services on behalf of the NHS. They took over the management of the practice in July 2019.
The practice has one male GP who is a partner of the Innovations Healthcare Solutions company. The GP is supported by two female and one male locum doctors. The practice employs a clinical pharmacist and a physiotherapist. The nursing team consists of a locum nurse practitioner, a practice nurse and a health care assistant, all female. An additional practice nurse had been recruited but had not started work in the practice at the time of the inspection. There are a team of reception and administrative staff all led by a practice manager, a reception supervisor and a patient support team leader. A business manager oversees the management of the practice.
The practice is open from 8am to 7.30pm Monday to Thursday and from 8am to 6.30pm on Fridays. When the practice is closed out of hours services are provided by Bedford On Call and can be accessed via the NHS 111 service.
Updated
16 December 2020
We carried out an announced comprehensive inspection at The Village Medical Centre on 27 February 2020. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, as part of our regulatory functions. The overall rating for the practice was inadequate and the practice was placed into special measures for a period of six months. The full comprehensive reports of the February 2020 inspection can be found by selecting the ‘all reports’ link for The Village Medical Centre on our website at www.cqc.org.uk
This announced comprehensive inspection on 10 to 12 November 2020 was carried out following the period of special measures to ensure improvements had been made and to assess whether the practice could come out of special measures.
We took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering how we carried out this inspection. We therefore undertook some of the inspection processes remotely and spent less time on site. We conducted staff interviews remotely on 10 to 11 November 2020 and carried out a site visit on 12 November.
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 requires improvement for all population groups.
We rated the practice as good for providing safe services because:
- The practice had systems in place to assess, monitor and manage risks to patient safety.
- Appropriate recruitment checks were in place for new staff members.
- Actions had been taken in response to risk assessments.
- Improvements had been made to the systems for the appropriate and safe use of medicines.
- There was a system in place for the practice to learn and make improvements when things went wrong.
- A member of the nursing team had received appropriate training to be the infection prevention and control (IPC) lead. This change had not been reflected in the IPC policy.
- Staff had received training to recognise sepsis symptoms. However, the poster displayed in the reception area to act as a prompt was not current and relevant.
We rated the practice as good for providing effective services because:
- New clinical guidance was shared with clinicians and discussed at the monthly practice clinical meetings.
- Care plans had been introduced for patients who required one. Patients received a copy of the agreed care plan.
- A system had been put in place to monitor unplanned admissions that ensured patients received a telephone call and a review following discharge.
- A system was in place to review the consultations and prescribing of the clinical staff, including locums and non-medical prescribers.
We rated the practice as requires improvement for providing caring services because:
- Patient satisfaction in the National GP Patient Survey had decreased from previous year’s results.
- An action plan had been put in place to improve patient satisfaction. However, it was too soon to assess the impact this had for patients.
We rated the practice as requires improvement for providing responsive services because:
- There remained dissatisfaction from some patients regarding access to care and treatment in a timely way.
- An action plan had been put in place to improve patient satisfaction. However, it was too soon to assess the impact this had for patients.
We rated the practice as good for providing well-led services because:
- Improvements had been made to the leadership and governance of the practice. A business manager had oversight of all management processes.
- The practice had a vision, set of values and strategy in place.
- Risk assessments had been completed and analysis of significant events and complaints. Action plans were in place to address areas for change and to improve patient satisfaction.
Whilst we found no breaches of regulations, the provider should:
- Update the infection prevention and control (IPC) policy to reflect the current lead for IPC within the practice.
- Provide information for reception staff to recognise sepsis symptoms that is current and relevant.
- Review how they can demonstrate quality improvement. For example, by the use of two cycle audits.
- Continue to improve and monitor patient satisfaction.
I am taking this service out of special measures. This recognises the significant improvements 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