The Care Quality Commission
  • Doctor
  • GP practice

Archived: Brompton Medical Centre

Overall: Good read more about inspection ratings

28A Garden Street, Gillingham, Kent, ME7 5AS (01634) 845898

Provided and run by:
Sydenham House Medical Group

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

All Inspections

21 June 2022

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Brompton Medical Centre on 30 April 2019. The overall rating for the practice was Requires Improvement.

After our inspection in April 2019 the provider wrote to us with an action plan outlining how they would make the necessary improvements to comply with the regulations.

We carried out an announced focussed inspection at Brompton Medical Centre on 29 June 2021. The overall rating for the practice was Requires Improvement.

After our inspection in June 2021 the provider wrote to us with an action plan outlining how they would make the necessary improvements to comply with the regulations.

The full comprehensive and focussed reports can be found by selecting the ‘all reports’ link for Brompton Medical Centre on our website at www.cqc.org.uk.

Why we carried out this inspection:

We carried out an announced focussed inspection at Brompton Medical Centre on 21 June 2022 under Section 60 of the Health and Social Care Act 2008, as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

How we carried out the inspection:

Throughout the pandemic 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 in line with all data protection and information governance requirements.

This included:

  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider
  • Requesting evidence from the provider
  • A short site visit

Our judgement of the quality of care at this service is based 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.

Our findings:

We have rated this practice as Good overall.

We rated the practice as Good for providing safe services because;

  • The provider had made improvements to the practice’s systems, practices and processes so that people were kept safe and safeguarded from abuse.
  • The arrangements for managing medicines had been improved so that patients were kept safe.

We rated the practice as Good for providing effective services because:

  • Improvements had been made so that patients’ needs were assessed, and care as well as treatment were delivered in line with current legislation, standards and evidence-based guidance.
  • Improvements had been made to the care and treatment (including reviews) of patients with long-term conditions, such as asthma, chronic obstructive pulmonary disease (COPD), hypertension, atrial fibrillation, and patients experiencing poor mental health (including dementia).
  • The provider was aware of published performance data relating to childhood immunisations as well as some cancer screening and was continuing to take action to improve uptake by relevant patients.

We rated the practice as Good for providing well-led services because:

  • Improvements had been made to processes for managing risks, issues and performance.
  • Clinical and internal audit were now being used to monitor quality as well as to make improvements.
  • The practice now had an active Patient Participation Group (PPG).

The areas where the provider should make improvements are:

  • Consider revising practice systems to ensure that all reviews of patients with mental health conditions (including dementia) follow relevant best practice guidance.
  • Continue with plans to improve uptake of childhood immunisations and some cancer screening by relevant patients.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

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

29 June 2021

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Brompton Medical Centre on 30 April 2019. The overall rating for the practice was Requires Improvement. The full comprehensive report on the April 2019 inspection can be found by selecting the ‘all reports’ link for Brompton Medical Centre on our website at www.cqc.org.uk.

After our inspection in April 2019 the provider wrote to us with an action plan outlining how they would make the necessary improvements to comply with the regulations.

Why we carried out this inspection:

We carried out an announced focussed inspection on 29 June 2021 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in April 2019. This report covers findings in relation to those requirements.

How we carried out the inspection:

Throughout the pandemic 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 in line with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using the telephone / video conferencing.
  • Requesting evidence from the provider.
  • A short site visit.

Our judgement of the quality of care at this service is based 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.

Our findings:

This practice is now rated as Requires Improvement overall.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services well-led? – Requires Improvement

We rated the practice as Requires Improvement for providing safe services because:

  • The practice’s computer system did not alert staff of all family and other household members of vulnerable children or adults.
  • Appropriate standards of cleanliness and hygiene were met.
  • Staff had the information they needed to deliver safe care and treatment.
  • Published results showed that the practice’s prescribing indicators were all now in line with local Clinical Commissioning Group (CCG) and England averages. However, on the day of our inspection we found that Patient Group Directions (PGDs) had not been completed correctly and improvements were required to the management of high-risk medicines prescribing.
  • There were effective systems for recording and acting on significant events as well as managing safety alerts.

We rated the practice as Requires Improvement for providing effective services because:

  • Patients’ needs were assessed, but care and treatment were not always delivered in line with current legislation, standards and evidence-based guidance.
  • The pandemic had had a detrimental effect on the practice’s ability to deliver some care as well as treatment. Improvements were required for some types of patient reviews as well as subsequent follow up activities.
  • Published performance results for diabetes indicators had improved and were now in line with or above local and national averages.
  • Staff had the skills, knowledge and experience to carry out their roles.
  • Staff worked together and with other organisations to deliver effective care and treatment.
  • Staff were consistent and proactive in helping patients to live healthier lives. However, improvements in the recording of the care and treatment of patients receiving palliative care were required.
  • The practice obtained consent to care and treatment in line with legislation and guidance. However, improvements in the recording of patients’ resuscitation statuses were required.

We rated the practice as Requires Improvement for providing well-led services because:

  • There was compassionate and inclusive leadership at all levels.
  • The practice had a vision to deliver high quality care and promote good outcomes for patients.
  • There were processes and systems to support good governance and management.
  • The practice’s processes for managing risks, issues and performance were not always effective.
  • Backlogs in relation to cancer screening were in the process of being addressed by the practice.
  • The practice engaged with the public, staff and external partners and was in the process of reinstating a patient participation group.

The areas where the provider must make improvements are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • Revise guidance for staff to follow during reviews of patients with chronic obstructive pulmonary disease (COPD) to help ensure the rationale for deciding if treatment changes are necessary or not is clearly documented in the patient record.
  • Continue to implement and monitor the outcome of plans to improve performance relating to child immunisations and cancer indicators.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

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

30 April 2019

During a routine inspection

This practice is rated as Requires Improvement overall.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at Brompton Medical Centre on 30 April 2019 under Section 60 of the Health and Social Care Act 2008, as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

  • There was an effective system for reporting and recording significant events.
  • The practice’s systems, processes and practices helped to keep people safe.
  • Risks to patients, staff and visitors were assessed, monitored and managed in an effective manner.
  • Staff had the information they needed to deliver safe care and treatment to patients.
  • The arrangements for managing medicines in the practice helped keep patients safe. Where prescribing performance for some antibiotics, some analgesics and some hypnotics were higher than local and national averages, the practice was taking action and had made improvements.
  • The practice learned and made improvements when things went wrong.
  • Patients’ needs were assessed, but care and treatment were not always delivered in line with legislation, standards and evidence-based guidance supported by clear pathways and tools.
  • Performance for diabetes and hypertension related indicators for 2017 / 2018 was below local and national averages. The practice had taken action and unverified data showed that improvements to performance in both these indicators had taken place.
  • Published results showed the childhood immunisation uptake rates for the vaccines given were lower than the target percentage of 95% or above in three out of the four indicators.
  • Staff had the skills, knowledge and experience to carry out their roles.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
  • Results from the national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was higher than local and national averages.
  • There were clear responsibilities, roles and systems of accountability to support good governance and management locally and at provider management team level.
  • Some processes to manage current and future performance were not yet sufficiently effective.
  • There were little or no clinical improvements as a result of clinical audit activity.
  • The practice had a vision to deliver high quality care and promote good outcomes for patients.
  • The practice was proactive at involving patients, the public, staff and external partners to support high-quality sustainable services.

The areas where the provider must make improvements are:

  • Ensure the care and treatment of patients is appropriate, meets their needs and reflects their preferences.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • Revise computerised records so that staff are alerted to family and other household members of child patients that are on the risk register.
  • Continue with plans to provide clinical staff with relevant vaccinations in a timely manner.
  • Continue to implement and monitor activities to sustain improvements to prescribing performance where these were higher than local and national averages.
  • Continue to implement and monitor activities to sustain improvement to performance for diabetes and hypertension indicators that were below local and national averages.
  • Continue to identify patients who are also carers to help ensure they are offered appropriate support.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

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