Archived: Lister Caretaking Practice

Updated 12 July 2018

The Lister Caretaking Practice provides primary medical services in the London Borough of Southwark to approximately 4,800 patients and is one of 38 GP surgeries in Southwark Clinical Commissioning Group (CCG). The practice operates at 1101 Peckham Road, Peckham, London, SE15 5LJ. The practice is based in a health centre in which two other GP practices are based, as well as a variety of other community healthcare providers.

The practice population is in the second most deprived decile in England. The practice population’s age demographic is broadly in line with the national average. However, there are proportionally more patients aged between zero and 49 years and proportionally fewer patients aged over 60.

The practice is managed by Hurley Clinical Partnership who manage 18 GP, urgent care and out of hours centres, the majority of which are in London. The GP team at the surgery is made up of three GPs providing 18 sessions per week. There is also a practice nurse who works six sessions per week and a full time practice manager, and a senior manager who has oversight of all three of Hurley Clinical Partnership’s premises in Southwark. The team is supported by seven other administrative and reception staff. The practice operates under an Alternative Provider Medical Services (APMS) contract.

The practice reception is open between 8:30am and 6:30pm Monday to Friday. At the time of the inspection extended hours had yet to be implemented, but following the inspection the practice has put in place extended hours from 6:30pm until 8pm on Wednesdays and 7am until 8am on Fridays. When the practice is closed patients are directed to contact the local out of hours service.

The practice is registered with the Care Quality Commission to provide the regulated activities of family planning; treatment of disease, disorder or injury; diagnostic and screening services; maternity and midwifery services.

Hurley Clinical Practice took over management of the practice following an inspection of the previous provider on 8 August 2017 where the service was found to be providing inadequate services.

Updated 12 July 2018

This practice is not currently rated. This is because the current provider has not been managing the practice for a sufficient time for a rating of the caring and responsive domains to be provided. This was the first inspection of this provider at this location. However, a previous provider was inspected on this location on 8 August 2017.

We carried out an announced comprehensive inspection at Lister Caretaking Practice on 1 May 2018. This inspection was a follow up to an inspection of a previous provider at this site on 8 August 2017 after which the previous provider was deregistered by the CQC. Although the practice was closed at that time, special measures were imposed. As such this inspection was a special measures review of the practice six months after the previous inspection report was issued.

Despite the closure, CQC stated that there were concerns at that time in the following areas:

• There were not systems in place to ensure that patients were kept safe. For example, systems for mitigating risks associated with infection control were not clear or effective.
• There were not systems and processes in place to ensure good governance. For example, there was no effective system in place for recalling patients with long term conditions who required regular reviews or for those who required periodic reviews of their medication including those on high risk medicines.
• There was an absence of clear leadership in key areas. For example the management of patient safety alerts. Although staff told us they felt supported by management, we were told that staff had only recently been given contracts of employment with legal terms and conditions. We were told that the practice PPG was not currently active.

The key questions following this inspection are rated as:

Are services safe? – Good

Are services effective? – Requires improvement

Are services caring? – Not rated

Are services responsive? – Not rated

Are services well-led? - Good

Population groups were not rated in this report as there were no ratings in the caring or responsive domains.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice had implemented defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• The practice had commenced a review of all patients with long term conditions at the practice to ensure that they had correctly been diagnosed and that they were on correct medicine.
• The practice’s Quality and Outcomes Framework (QOF) score was lower than the national average, and routine follow ups for some patient groups had yet to be scheduled.
• The practice had undertaken audits of areas that were highlighted as high risk when they took over management of the practice. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Information about services and how to complain was available.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements as they are in breach of regulations are:

• Assess and review the risks to the health and safety of service users with regard to the follow up and management of patients who require regular review and management. This includes patients with long term conditions, patients whose circumstances make them vulnerable and patients experiencing poor mental health.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Updated 12 July 2018

Updated 12 July 2018

Updated 12 July 2018

Updated 12 July 2018

Updated 12 July 2018

Updated 12 July 2018