Dearden Avenue Medical Practice

We carried out an announced comprehensive inspection at Dearden Avenue Medical Centre on 27 July 2023. Overall, the practice is rated as good.

Safe-good

Effective – requires improvement

Caring - good

Responsive – good

Well-led – good

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

Why we carried out this inspection

We carried out this inspection due to a change in registration.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included

• Conducting staff interviews using video conferencing.
• 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.
• 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 found that:

• Staff had received appropriate training and there were effective health and safety risk assessments.
• Patients received effective care and treatment that met their needs, but there were some areas that required improvement such as effective medicine review and monitoring of patients with long term conditions. We were informed shortly after the inspection that clinicians had reviewed and addressed the issues raised in the clinical searches to ensure patients received the necessary care and treatment.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way which was reflected in the latest results of the National Patient Survey.
• The provider had developed a clear vision for the management of the practice, and the small staff team felt supported in their development and described a positive working culture.

In addition the provider should:

• Take steps to implement quality improvement activities such as clinical audits and re-audits to monitor the effectiveness of clinical care and improve patient outcomes.
• Oversee and improve the management of safety alerts to ensure these processes are managed and embedded into clinical practice.
• Oversee and improve the way clinical searches are completed to ensure potential risks are identified, managed and embedded into clinical practice.
• Continue to monitor and improve childhood immunisation rates.
• Continue to monitor and improve cervical screening rates.
• Explore opportunities to gather patient feedback.

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