Manchester Road East Medical Practice

Updated 14 December 2023

Manchester Road East Medical Practice is located in the Little Hulton area of Salford at:

4 Longshaw Drive

Worsley

Manchester

M28 0BB

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 practice is situated within the Greater Manchester Integrated Care System (ICS) and delivers Personal Medical Services (PMS) to a patient population of about 2298. This is part of a contract held with NHS England. The practice is part of a wider network of GP practices, the Walkden and Little Hulton Primary Care Network (PCN).

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the second lowest decile (two of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 94% White, 2% Asian, 2% Black and 2% Mixed, and other ethnicities.

There is a single-handed GP (male) and a salaried GP (female) who works half a day each week. There is a practice nurse, a practice manager and a team of administrative staff.

The practice is open between 8am and 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments. Patients requiring a GP outside of normal working hours are advised to contact the surgery and they will be directed to the local out of hours service which is provided through NHS 111. Additionally, patients can access GP services in the evening and on Saturdays through the

extended access scheme.

Updated 14 December 2023

We carried out an announced inspection at Manchester Road East Medical Practice on 18 July 2023. Overall, the practice is rated inadequate.

The ratings for each key question are:

Safe - inadequate

Effective – requires improvement

Caring - good

Responsive – requires improvement

Well-led – inadequate

Why we carried out this inspection

We carried out this inspection due to a change in the provider’s registration. The practice had moved to new premises in 2022. This inspection was a comprehensive inspection of all five key questions.

How we carried out the inspection

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 (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Conducting an interview with the provider using video conferencing.
• Requesting evidence from the provider.
• A short site visit.

• Issuing questionnaires to staff.

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 rated the provider inadequate for providing safe services:

• Recruitment systems were not effective and relevant legislation was not adhered to.
• The process for managing significant events was not effective.
• Safety alerts were not appropriately actioned.
• Patients prescribed high risk medicines were not always appropriately monitored.
• Emergency medicines had not been considered, and were not safely stored.
• Actions had not been taken following the infection prevention and control audit.
• Information provided to locum GPs was not accurate.

We rated the provider requires improvement for providing effective services:

• Up to date clinical guidance was not always being followed.
• The system for keeping clinicians up to date with current guidance was not effective.
• Evidence of training for the practice nurse was not held by the practice.
• There was no documented clinical supervision for the newly qualified practice nurse.
• Childhood immunisation and cervical screening data was below target.

We rated the provider good for providing caring services:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

We rated the provider requires improvement for providing responsive services:

• The process for identifying, investigating, responding to and learning from complaints was not effective.

We rated the provider inadequate for providing well-led services:

• Leaders had not identified the risks we found during the inspection.
• Policies were not always followed and did not always contain enough information to provide relevant guidance.
• Systems for managing risks were not effective.
• Information, such as from complaints and significant events, was not recorded and acted on.
• We did not see examples of continuous learning and improvement.
• There were no arrangements in place to access a Freedom to Speak Up Guardian.

We found 4 breaches of regulation. The provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Ensure there is an effective system for identifying, receiving, recording, handling and responding to complaints made by patients and other persons in relation to the carrying on of the regulated activity.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

In addition, the provider should:

• Take steps to improve the uptake of childhood immunisations and cervical screening.
• Monitor the vaccination status of non-clinical staff and take action where required.

I am placing this service in special measures. Services placed in special measures will be inspected again within 6 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 6 months if they do not improve.

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 Health Care