Archived: Crest Medical Centre

Updated 24 October 2016

Crest Medical Centre is located in a residential area of Brent and provides a general practice service to around 4,300 patients. The practice has a younger, more diverse population than the English average. 

The clinical practice team comprises of four GPs (male and female). The practice also offers appointments with the practice nurses, health care assistants and phlebotomy appointments. The practice employs a practice manager and receptionists.

The practice opens from 8:45am until 12:45pm every weekday and then from 4:45pm until 7.00pm Monday, Tuesday and Wednesday and until 6:30pm on Friday. The practice provides information about out of hours services at the practice and by telephone. The practice does not have a website.

The practice is registered to provide the regulated activities of diagnostic and screening procedures, maternity and midwifery services, surgical procedures and treatment of disease, disorder and injury.

Updated 24 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Crest Medical Centre on 25 March 2015. At that time we found the practice was breaching legal requirements in relation to its recruitment practice and the practice was rated as requires improvement for providing safe care. The previous comprehensive inspection report can be found by selecting the ‘all reports’ link for Crest Medical Centre on our website at www.cqc.org.uk.

Following that inspection, the practice wrote to us with details of the actions they would take to meet the legal requirements.

We undertook this focused inspection to check that the practice had followed their plan and to confirm that they now met the legal requirements. This inspection did not include a visit to the practice. This report covers our findings from the focused inspection.

We found the practice was now providing safe services and have rated the practice as good for providing safe care.

Our key findings across the areas we inspected were as follows:

• Systems and processes were in place to keep people safe. The practice had taken steps to ensure risks to patients were assessed and well managed.
• The practice had carried out all necessary recruitment checks and could evidence this. The practice recruitment policy specified the recruitment checks which were required and these were in line with the relevant regulations.
• All staff had completed training on safeguarding children and vulnerable adults to the relevant level. The practice kept a record of staff training and alerted staff members when refresher training was due. 

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 September 2015

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. The practice nurse specialised in diabetes and had undertaken training for this role. The practice was able to refer patients with diabetes to a local ‘one stop shop’ diabetic clinic. The specialist diabetic nurse had attended meetings with clinical staff to review patient care and offer advice on good practice. Eighty-four per cent of patients on the diabetic register had received their annual influenza vaccination in comparison to 93% which was the national average.

Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 10 September 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people on the child protection register.

The practice offered antenatal care, six week mother and baby checks and childhood immunisations. Patients could book an appointment with the practice nurse for these services. Ninety four per cent of children under two had received their childhood immunisations, with 100% of children under five receiving the full range of immunisations. One hundred per cent of children who had moved to the United Kingdom from abroad had received their hepatitis B vaccination. Staff informed us that in the case of a child from abroad not having an immunisation record they were offered the full range of childhood immunisations.

We saw good examples of referrals to specialist services for children. For example to CAMHS (children and families mental health services) as a result of assessment and consultation with the family.

Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors.

Updated 10 September 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

All patients over the age of seventy five had a named GP. A privately hired physiotherapist worked at the practice three times a month and offered a service to older patients with mobility problems. Sixty-seven per cent of older patients had received the seasonal flu vaccination, this compared to the national average of 73%.

Updated 10 September 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Extended hours were available on Monday, Tuesday and Wednesday until 7:15pm for patients who were not able to see their GP during normal working hours or school hours. Extended appointments were available with the practice nurse on Monday until 7:15pm. Nine GP telephone consultations were available daily.

NHS Health Checks were offered to patients aged 40-74 years of age who were not already known to have any long-term conditions. The surgery achieved above their practice target last year on delivering NHS Health Checks.

Updated 10 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Ninety seven per cent of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. GPs supported patients to access the mental health services they required within an NHS setting. One of the GPs at the practice had a special interest in mental health and had also worked within a mental health setting. As a result of this patients at the practice were referred to this GP by other GPs in the practice.

Updated 10 September 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients with a learning disability. It had carried out annual health checks for people with a learning disability and 95% of these patients had received a follow-up review.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours. However, the practice training record did not indicate that all staff had received formal safeguarding training.