Stirling Medical Centre

We carried out an announced inspection at Stirling Medical Centre on 21 and 22 March 2022. Overall, the practice is rated as Requires Improvement.

We rated each key question as follows:

Safe - Requires Improvement

Effective - Requires Improvement

Caring - Good

Responsive - Good

Well-led - Requires Improvement

Why we carried out this inspection.

This inspection was a comprehensive inspection. It was the first inspection since registration of the service as an individual GP in 2020 after the previous partnership was dissolved.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, considering 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 Requires Improvement overall.

We found that:

• The practice had not always provided care in a way that kept patients safe and protected them from avoidable harm. This was because recruitment polices were not always fully implemented and there were gaps in some management of medicine systems.
• The majority of patients received effective care and treatment that met their needs. However, not all patients had had their long-term conditions reviewed in a timely manner and some patients prescribed high risk medicines were not being adequately monitored.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• 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, and this had been maintained throughout the pandemic.
• Data showed good levels of patient satisfaction with the service and no complaints had been received by either the practice or CQC.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care. However, there were some areas relating to recruitment, oversight of training, staff appraisal and safe management of medicines which had had not been well managed and associated risk had not always been assessed and minimised.

We found three breaches of regulations. The provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• 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

The provider should:

• Review systems relating to monitoring indemnity insurance for locum staff.
• Assure themselves work to the buildings electrical system has been completed.
• Review and improve the practice website to make information about support groups available.
• Share the practice vision and strategy and information about the freedom to speak up guardian with staff.
• Involve patients in the running of the practice through a patient participation group.
• Review systems to enable smart cards so staff have access to all the areas they require for their role.

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