The Care Quality Commission
  • Doctor
  • Independent doctor

Archived: Chesterton Medical Centre

Overall: Good read more about inspection ratings

Union Lane, Cambridge, Cambridgeshire, CB4 1PX

Provided and run by:
Cambridge Doctors On Call Limited

Important: This service was previously managed by a different provider - see old profile

All Inspections

3 November 2015 and 4 November 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chesterton Medical Centre on 3 and 4 November 2015. Overall the service is rated as good.

Our key findings across all the areas we inspected were as follows:

  • Staff understood their needs to raise concerns. There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events and for sharing learning.
  • Risks to patients were generally very well managed. However, the service did not have robust systems to assure itself that health and safety issues were being addressed where services were provided to patients.
  • Patient care was assessed and delivered in a timely way according to need. The service performed well against the National Quality Requirements for GP out-of-hours care.
  • Patients said they were treated with compassion, dignity and respect and were satisfied with the care and treatment they received from the service.
  • Information about services and how to complain was available and easy to understand. The service responded with care and compassion when responding to sensitive complaints.
  • Adherence to appointment times given for face to face consultations was frequently raised in patient feedback.
  • The primary care centres where patients were seen had good facilities and were well equipped to treat patients and meet their needs. Vehicles used for home visits were clean and also well equipped.
  • There was strong and clear leadership. Staff felt supported by senior management and directors who were visible on shifts to support the smooth running of the service.
  • The provider was aware of and complied with the requirements of the Duty of Candour.
  • The service worked proactively with other organisations and with the local community to develop services that supported hospital admission avoidance and improved the patient experience.
  • The service had a clear vision which focussed on quality and safety. The service was responsive to feedback received and used information available proactively to drive service improvements.

We saw areas of outstanding practice:

  • Despite meeting national quality requirements the service actively investigated the small proportion of patients where breaches had occurred. As a result of these exercises the service had employed a prescribing pharmacist at peak times to deal with prescribing and medicine queries in a more timely way and to free other clinicians to see patients. Early signs had shown this was having a positive impact. For example, in one day they had been able to deal with 37 out of 38 medicine queries received with only six requiring a face to face consultation with a clinician.

The areas where the provider should make improvement are:

  • To assure itself that appropriate arrangements are in place across all primary care sites in relation to health and safety and the management of the premises.

  • Continue to ensure patient expectations around appointment times are managed.

  • Maintain a robust audit trail for the management of ‘stat dose’ medicines administered to patients on site.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During a check to make sure that the improvements required had been made

We carried out this follow up review to report on the actions the provider had taken to address the compliance action made at the previous inspection in June 2013. We followed up one outcome area of non-compliance identified in a previous inspection in June 2013. We reviewed evidence during our new approach inspection that was carried out in March 2014 and this demonstrated the provider was compliant with this essential standard.

12/03/2014

During a routine inspection

Cambridgeshire Doctors on Call is also known as Urgent Care Cambridgeshire. It provides an evening and weekend out-of-hours primary care service for patients in Cambridgeshire. The service is responsible for providing primary care when GP surgeries are closed. It provides medical services from five primary care centres based in Cambridge, Ely, Doddington, Wisbech and Huntingdon.

All the patients we spoke with were very complimentary about the service they received. We saw the results of a patient survey that showed patients were consistently pleased with the service they received.

The provider had responded very effectively to safeguarding concerns in a previous CQC inspection and had made all the improvements necessary to keep people safe.

The provider regularly met with the local clinical commissioning group (CCG) to discuss service performance and improvement issues. There was generally a very good relationship between the provider and the CCG. The provider was fully engaged in the local health economy and was proactive in responding to peoples’ needs.

The leadership team was very visible and staff found them very approachable. There were excellent governance and risk management measures in place.

22, 26 June 2013

During a routine inspection

We received many positive comments from people about their overall experience with Urgent Care Cambridgeshire. Those we spoke with during our visits to two of the service's primary care centres told us that their initial call had been answered quickly and they had received a call back from a clinician promptly after that. One person said, 'I've had to use this service and base a few times over recent weeks, and it's been good each time.' People told us that the call handlers and clinicians had listened to them well and had understood the nature of their illness. Two people described the service as 'Really good'. However, one person told us that some of the children's toys available in the waiting room were very noisy, making it unpleasant to be in. Another person reported that the signage to the service's Cambridge centre was poor. In January 2013 the Cambridgeshire Local Involvement Network published a report of the findings of a survey they had conducted with people who had used Urgent Care Cambridgeshire. This report stated, '82% of respondents who attended an out of hours primary care centre and those who required a home visit by a GP felt they were seen within a reasonable timeframe. 91% of those who attended an out of hours primary care centre and 90% of those who required a home visit by a GP reported they had confidence and trust in the out of hours doctor they saw.'

We spoke with staff from 29 GP practices. All reported that they had confidence in the service provided by Urgent Care Cambridgeshire. They told us that they received good quality information about their patients who used the service; that their patients did not have a long time to wait at the centres and that their patients received a home visit if required. They stated that the standard of communication between their practice and the service was excellent. One GP commented, 'We have the same IT system so we find that overnight reports come through quickly and they contain relevant information'. Another stated, 'We hear very little negative feedback regarding the service from our patients. They accept that there will inevitably be some delay to be seen but the quality of the care given seems to be of a high standard'. GPs we spoke with were particularly pleased that the service used mostly local doctors who knew the health and social care resources in the area well.

Staff we spoke with during our visits told us that they enjoyed their job; that they felt supported and worked well as a team. However, some raised concerns about the forthcoming changes within the service and the impact this might have on them and their shift patterns.

Overall we found that people received responsive and effective out of hours GP service from Urgent Care Cambridge. Staff were well trained and the systems in place to manage people's medication were robust. However, we found that staff did not take adequate and timely action in order to protect vulnerable adults and children.