• Doctor
  • GP practice

Archived: Foundations Also known as Foundations - 7 Harris Street

Overall: Outstanding read more about inspection ratings

7 Harris Street, Middlesbrough, Cleveland, TS1 5EF (01642) 251053

Provided and run by:
Foundations

Important: The provider of this service changed. See old profile

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Background to this inspection

Updated 10 December 2018

Foundations, Harris Street, Middlesbrough, TS1 5EF is one of two GP practices operated by the same provider (Foundations) and delivers a Personal Medical Services (PMS) contract to approximately 1000 patients within Middlesbrough who are seeking asylum or have refugee status. The link to the practice website is

Foundations (Harris Street) is situated in the centre of a deprived town in Teesside. The practice scored one on the Index of Multiple Deprivation 2015 (IMD) which is the official measure of relative deprivation for small areas in England. The Index of Multiple Deprivation ranks every small area in England from one (most deprived area) to ten (least deprived area).

In England, people living in the least deprived areas of the country live around 20 years longer in good health than people in the most deprived areas.

All of the patients on the practice list are considered to be vulnerable. There is a much higher than average cohort of patients in the aged 15-44 category. There are only three patients aged 65 or over. There are 181 children registered with the practice. Male patients account for 75% of the practice patient list, the remaining 25% are female.

In addition to this, there is an exceptionally high unemployment rate (60%) compared with the national average (5%) for practice lists. This is a direct effect of the refugee or asylum status of its patients, as Home Office rules do not allow refugees and asylum seekers to gain employment without exceptional permission. The practice reports that many of its patients are highly skilled or professional individuals.

There are approximately 41 different languages spoken by patients on the practice list and the provider relies heavily on the use of face-to-face translators. Some of the languages cannot be interpreted by the dedicated translation service and, in addition, there are often unique dialects within those languages. As such, communication is one of the most difficult challenges faced by the practice.

Many patients on the practice list have experienced trauma in their country of origin, or on their journey to the United Kingdom. Some have spent extensive periods of time in immigration removal centres.

The practice partnership is made up of four partners; one is a male mental health nurse / psychotherapist, one is a female business partner. There is also a male nurse practitioner and a male GP who make up the partnership. The practice has faced ongoing difficulties with GP recruitment and staffs its rota with regular locum GPs and agency nurses, in addition to the core of permanent clinicians. There is a female service lead who does a mix of management and clinical work. There are administrators/receptionists who also do some hours as health care assistants. There is an employed safeguarding nurse who works across both sites.

The practice is registered to carry out the following regulated activities; Diagnostic and screening procedures, Maternity and Midwifery, and Treatment of Disease, Disorder or injury.

Overall inspection

Outstanding

Updated 10 December 2018

This practice is rated as outstanding overall. Previous rating October 2018 (date of inspection, not publication) – Good:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Outstanding

Are services responsive? – Outstanding

Are services well-led? - Good

The key question at this inspection (27 November 2018) is rated as:

Are services safe? – Good

We carried out an announced focused inspection at Foundations – Harris Street on 27 November 2018. This was done as part of our inspection programme, in response to areas which are rated as ‘requires improvement’. We undertook a full comprehensive inspection of this service in October 2018 and found that the ‘safe’ key question was rated as ‘requires improvement’. This was because:

  • There was no medical oxygen kept on site at Foundations.
  • Staff did not have the proper authorisation in place to administer medicines, under a Patient Specific Direction.

At this inspection we found:

  • The practice had stocked a medical oxygen cylinder which had, in addition, appropriate masks and tubing for use in a medical emergency.
  • All staff were familiar with the location of the oxygen and emergency equipment.
  • There was a monitoring checklist which was signed and dated and demonstrated regular checking of all this equipment.
  • Patient Specific Directions were signed, dated and authorised in the correct way.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.