Background to this inspection
Updated
28 June 2018
The provider of the Regulated Activities at Thurmaston Health Centre at the time of our inspection was Leicester Medical Group. It provides primary medical services to approximately 7,800 patients on the edge of the City of Leicester. The practice list had continued to grow and had increased from 6,794 in January 2016.
Leicester Medical Group is a partnership of two GPs. One of the GPs was primarily responsible for Thurmaston Health Centre while the other is responsible for the other Leicester Medical Group practice at Aylestone Surgery.
Services are provided from a single location at 573a Melton Road, Thurmaston Leicester.
The provider is registered to provide the regulated activities of;
• Diagnostic and screening procedures
• Maternity and midwifery services
• Surgical procedures
• Treatment of disease, disorder or injury
The provider was not registered to provide the regulated activity of family planning at the time of our inspection although in December 2017 we found that the service was nevertheless being provided as coils were being fitted and removed.
The registered manager is registered to manage the regulated activities of;
• Diagnostic and screening procedures
• Surgical procedures
• Treatment of disease, disorder or injury
Maternity and midwifery services
At the time of our inspection in December 2017 they were not registered to manage the regulated activity of maternity and midwifery services but CQC took action to require the provider to ensure that both the provider registration is correct and that all the regulated activities are managed by a registered manager. Subsequently the registered manager successfully applied to be registered to provide the regulated activity of maternity and midwifery.
No application was received to register to provide the regulated activity of family planning and both during and following this inspection we found evidence that this was still being provided.
There are two GP partners, one nurse practitioner, one part time practice nurse and one part time locum practice nurse, two health care assistants and a clinical pharmacist. They are supported by a long term locum GP and a team of management, reception and administrative staff. The practice is an accredited training practice but at the time of inspection there were no Foundation Year doctors in place at the practice.
We had been told at the December 2017 inspection that there were plans to terminate one of the GP partnerships that the lead GP had entered into and for the other partner to move to Thurmaston Health Centre as a salaried GP, working part time.
It is not a dispensing practice.
Deprivation levels in the registered population are relatively low. The practice has slightly more than the average percentage of female patients aged 45-49 and slightly more than the average percentage of male patients aged 35-39. Otherwise the practice demographics of the practice registered list reflect those of practices nationally.
The practice is situated within a purpose built modern facility which is accessible to all and has ample on site car parking. The building is accessible to those with restricted mobility and those with mobility scooters and prams or pushchairs.
The practice lies within the West Leicestershire Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.
The practice has opted out of the requirement to provide GP consultations when the surgery is closed. Out- of-hours services are provided by Derbyshire Health United, which is accessed via the NHS 111 service.
Updated
28 June 2018
This practice is rated as Inadequate overall. This rating was given at our previous inspection 14 December 2017.
We carried out an unannounced focused inspection of Leicester Medical Group on 10 April 2018. This inspection was undertaken to follow up on breaches of regulations which had been identified at our previous inspection in December 2017 in relation to safe care and treatment and governance arrangements within the practice. We issued the practice with two warning notices requiring them to achieve compliance with the regulations set out in those warning notices by 14 March 2018. This focused inspection only included the safe and well led key questions.
At this inspection we found that all the requirements of the two warning notices had not been met. Additionally we found further serious concerns.
Our key findings across the areas we inspected for this focused inspection were as follows:
- Patients were at risk of harm because there was a lack of monitoring of the care and treatment of patients.
- There was a failure of some clinicians to treat patients in accordance with national clinical guidelines and we found examples of poor care and treatment which put patients at serious risk of harm.
- There were 38 outstanding tasks on the practice computer system dating back to mid-March 2018. This put patients at risk of delays in diagnosis, further investigation and treatment. One patient had not been informed that their test results indicated a diagnosis of diabetes.
- There was not an effective system to summarise patient records. We found 356 patient records in different areas of the practice which were waiting to be summarised. The practice were unaware of how many records were not summarised or how to identify this and therefore unable to say how long the records had been unsummarised. This put patients at risk as summarising patient records protects patients by ensuring that relevant and key information about patients is recorded and therefore available should another clinician need to refer to those records in order to ascertain what would be safe care and treatment for a particular patient.
- Actions had been taken to improve the system for safeguarding children but the system still required strengthening.
- At our inspection in December 2017 there was not a clear and effective system for reporting and acting on significant events. We found this was still the case which meant the practice did not have adequate systems to prevent or minimise the risk of safety incidents recurring or identifying and sharing learning from them.
- We found that not all blank prescription forms were kept securely.
- At this inspection we still had concerns with regard to the clinical oversight and governance arrangements in place.
- Performance of employed clinical staff could not be demonstrated through audit of their consultations, prescribing and referral decisions.
- The practice did not have effective systems to support the appropriate and safe management of medicines.
- During the course of our inspection we found out of date medicines in the practice and medicines which were not stored safely and could be accessed by patients. We also found confidential patient information which was accessible to patients in unlocked rooms.
- Medicines were administered to patients without relevant authorisation by a GP.
- Patients’ health was not always monitored in a timely manner to ensure medicines were being used safely and followed up on appropriately.
The provider is no longer providing care or treatment from Thurmaston Health Centre.
As a result of the inspection team’s findings from the unannounced focused inspection, as to non-compliance, but more seriously, the risk to service users’ life, health and wellbeing, the Commission decided to issue an urgent notice of decision to impose conditions on the provider’s registration to stop them carrying on regulated activities from this location under section 31 of the Health and Social Act 2008. The notice was served on the provider on 11 April 2018 and took immediate effect which means the provider is no longer able to carry on regulated activities from Thurmaston Health Centre, 573a Melton Road, Thurmaston, Leicester LE4 8EA.
The practice is still open but services are being provided by a different provider.