We carried out a review of the data available to us about Chelsea Medical Services 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 Chelsea Medical Services, you can give feedback on this service.
We carried out an announced inspection at Chelsea Medical Services on 20 April 2022. Overall, the practice is rated as Good.
The ratings for each key question are as follows:
Safe - Good
Effective - Good
Caring - Good
Responsive - Good
Well-led - Good
Following our previous inspection on 30 November 2020 the practice was rated Requires Improvement overall and for the Safe and Effective key questions. It was rated Good for being Caring, Responsive and Well-Led.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Chelsea Medical Services on our website at www.cqc.org.uk
Why we carried out this inspection
This inspection was a focused inspection to follow up on:
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:
Our findings
We based our judgement of the quality of care at this service on a combination of:
We have rated this practice as Good overall
We found that:
Whilst we found no breaches of regulations, the provider should:
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
Chelsea Medical Services is a provider registered with CQC. Following a comprehensive inspection on 11 November 2019, we rated the practice inadequate overall and in the key questions of safe, effective and well-led. Responsive was rated requires improvement and caring was rated as good.
At the November 2019 inspection, we found concerns in relation to safeguarding, recruitment, staff training, infection prevention and control, high-risk medicines monitoring, medicine management, storage of patients' records, health & safety monitoring, patient safety alerts and general governance systems. The practice was placed into special measures and issued warning notices for breaches of Regulations 12 and 17 of the Health and Social Care (HSCA) 2008 (Regulated Activities) Regulations 2014.
We carried out an announced desk-top based focused inspection of Chelsea Medical Services on 22 and 29 September 2020 to review compliance with the warning notices issued following the November 2019 inspection. That inspection was unrated.
At the September 2020 inspection, we found the provider had made some improvement in providing safe services. In particular, we found the provider had made improvements in their systems and processes in relation to safeguarding, recruitment, infection prevention and control, high-risk medicine monitoring, medicine management, storage of patients' records, health and safety monitoring and compliance with patient safety alerts.
We found the provider had made some improvement in providing effective services. In particular, we found the provider had made improvements concerning ‘effective staffing’, such as oversight of medical staff and monitoring patient outcomes.
We found the provider had made some improvement in providing well-led services in relation to good governance and had implemented systems and processes in response to the findings of the previous inspection outlined in the warning notice for Regulation 17 (Good governance).
We found the provider to be compliant with the warning notices issued for breach of regulation 12 and 17.
This report relates to the findings of our comprehensive inspection of the practice, that took place on 30 November 2020. We rated this practice as requires improvement overall. The safe and effective key questions were rated requires improvement; caring, responsive and well-led were rated good. We rated two population groups: families, children and young people and working age people as requires improvement. The remaining population groups: older people, people with long-term conditions, people whose circumstance may make them vulnerable and people experiencing poor mental health (including those with dementia) were rated as good.
Reports of the previous inspections can be found by selecting the 'all reports' link for Chelsea Medical Services on our website at www.cqc.org.uk.
We based our judgement of the quality of care at this service on a combination of:
We rated the practice requires improvement for providing safe services because:
We rated the practice requires improvement for providing effective services because:
We rated the practice good for providing caring services because:
We rated the practice good for providing responsive services because:
We rated the practice good for providing well-led services because:
The areas where the practice must make improvements are:
(Please see the specific details on action required at the end of this report).
The areas where the practice should make improvements are:
I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.
Details of our findings are set out in the evidence table.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care
We carried out an announced desk-top based focused inspection of Chelsea Medical Services on 22 and 29 September 2020.
The practice was previously inspected on 11 November 2019, when they were rated inadequate overall (inadequate in safe, effective and well-led) and placed in special measures. At that inspection we issued warning notices for breaches of Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance).
The report of the previous inspection can be found by selecting the 'all reports' link for Chelsea Medical Centre on our website at www.cqc.org.uk.
This desk-based focused inspection, on 22 and 29 September 2020, was to follow-up on the warning notices issued following the November 2019 inspection. At that inspection we found concerns in relation to safeguarding, recruitment, staff training, infection prevention and control, high-risk medicines monitoring, medicine management, storage of patients' records, health & safety monitoring, patient safety alerts and general governance systems.
We based our judgement of the quality of care at this service on a combination of:
This report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC's regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information without visiting the provider.
This was an unrated inspection.
We found the provider had made improvements in providing safe services. In particular we found the provider had made improvements in their systems and processes in relation to safeguarding, recruitment, infection prevention and control, high-risk medicine monitoring, medicine management, storage of patients' records, health and safety monitoring and compliance with patient safety alerts.
We found the provider had made improvements in providing effective services. In particular we found the provider had made improvements in relation to effective staffing and monitoring patient outcomes. However, improvement was still necessary in relation to cervical screening and childhood immunisation achievement rates.
We found the provider had made improvements in providing well-led services in relation to good governance and had implemented systems and processes in response to the findings of the previous inspection outlined in the warning notice for Regulation 17 (Good governance).
The areas where the practice must make improvements are:
The areas where the practice should make improvements are:
The service will remain in special measures and this will be reviewed at a follow-up comprehensive inspection in line with our current inspection criteria.
Details of our findings are set out in the evidence table.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care
We carried out an announced comprehensive inspection Chelsea Medical Services on 11 November 2019 as part of our inspection programme.
We inspected this practice on one previous occasion, on 18 August 2015, and the practice was rated as good overall. We rated all domains and all patient population groups as good.
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, including all population groups, overall.
We rated the practice as inadequate for providing safe services because:
•The practice did not have clear systems and processes to keep patients safe.
•The practice did not have reliable systems and processes to keep patients safeguarded from abuse.
•The practice did not have reliable infection prevention and control practices in place.
•The practice did not maintain adequate records to monitor and manage the cold chain effectively.
•The practice did not have complete fire safety systems in place.
•The practice did not have reliable systems in place to manage the practice premises safely.
•The practice did not have appropriate systems in place for the safe management of medicines.
We rated the practice as inadequate for providing effective services because:
•There was limited monitoring of the outcomes of care and treatment.
•The provider could not demonstrate they undertook any quality improvement activity.
•The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.
•Some performance data was significantly below local and national averages.
This area affected all population groups; so, we rated all population groups in the effective domain as inadequate.
We rated the practice as inadequate for providing well-led services because:
•Leaders could not show that they had the capacity and skills to deliver high quality, sustainable care.
•The practice did not have safe systems regarding the management of patients on high-risk medicines.
•The practice did not have a fail-safe system to manage patient safety alerts.
•The practice did not have clear and effective processes for managing risks, issues and performance.
•The practice did not have an appropriate fail-safe system in place for the safe management of patients who had been referred via the two-week wait urgent referral system.
•The practice did not have an appropriate fail-safe system in place to monitor and manage cervical screening for female patients.
•The provider did not have a safe or effective recruitment system in place.
•While the practice had a clear vision, that vision was not supported by a credible strategy.
•The practice culture did not effectively support high quality sustainable care.
•The overall governance arrangements were ineffective.
•The practice did not always act on appropriate and accurate information.
•We saw limited evidence of systems and processes for learning, continuous improvement and innovation.
These areas affected all population groups so we rated all population groups as inadequate.
We rated the practice as requires improvement for responsive services because:
•Patients could access appointments in a timely way.
•All patients had a named GP who supported them in whatever setting they lived, and conducted home visits when required.
We rated the practice as good for providing caring services because:
•Staff dealt with patients with kindness and respect and involved them in decisions about their care.
•Patients made positive comments about the care and treatment they received.
The areas where the provider must make improvements are:
•Ensure that care and treatment is provided in a safe way.
•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:
•Ensure there is a comprehensive complaints system in place.
•Develop a strategy to address low childhood immunisations achievement rates.
•Develop a strategy to address low cervical smear achievement rates.
•Develop a strategy to improve national cancer screening programme achievement rates.
•Review the availability of practice information in easy read format.
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 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 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