Stone Cross Medical Centre

We carried out an announced inspection at Stone Cross Medical Centre between 13 to 21 May 2021. Overall, the practice is rated as Good.

The ratings for each key question are as follows:

Safe - Good

Effective – Requires Improvement

Caring – Good

Responsive - Good

Well-led – Good

Following our previous inspection on 8 January 2020, the practice was rated Inadequate overall and for all key questions, except for providing caring services which was rated as requires improvement. The practice was placed into special measures. A GP Focussed Inspection Pilot (GPFIP) between 14 September 2020 and the 2 October 2020 was also carried out to check what improvements had been made.

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

Why we carried out this inspection

This inspection was a comprehensive inspection to follow up on any breaches of regulations and ‘shoulds’ identified in the previous inspection.

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:

• 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 shortened 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 Good overall and requires improvement for all population groups, except for older people and people whose circumstances make them vulnerable which we have rated as good.

We found that:

• Systems had been strengthened to ensure safeguarding registers were monitored effectively. Regular reviews of the registers were carried out to ensure all the relevant information had been recorded appropriately and safeguarding arrangements protected patients from avoidable harm.
• Quality performance indicators demonstrated some significant decreases, specifically in mental health and dementia indicators. Some areas of long term condition management needed strengthening to ensure patients received the appropriate monitoring. Following the inspection, the practice provided unverified data for 2020/2021 which showed improvements in agreed care plans for people experiencing poor mental health and people with dementia.
• Action plans were in place to review quality indicators and regular audits were completed to improve patient outcomes.
• Effective procedures for the management of medicines had been implemented to ensure patients received the appropriate reviews.
• Risk management processes had been addressed and we found assessments of risks had been completed. These included fire safety, health and safety, and infection control. This ensured that risks had been considered to ensure the safety of staff and patients and to mitigate any future risks.
• Continuous monitoring of practice procedures, clinical outcomes, clinical registers and staff training was now in place to ensure improvements were maintained.
• We found improvements in the management of patients’ care and treatment. This included the appropriate monitoring of patients on high risk medicines.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. This included individual risk assessments for staff, the use of personal protective equipment (PPE) and enhanced infection control procedures.
• Governance arrangements had been strengthened to ensure risks to patients were considered, managed and mitigated appropriately.
• The practice had implemented a system of peer review for the clinical team. On reviewing a sample of patient records we found prescribing decisions were in line with recognised guidance and consultations contained relevant information.

The areas where the provider should make improvements are:

• Continue to encourage patients to attend cervical screening appointments.
• Encourage patients to attend childhood immunisation appointments

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

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.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care