Thatched House Medical Centre - Care Quality Commission

Background to this inspection

Updated 7 June 2017

Thatched House Medical Centre provides GP primary care services to approximately 4000 people living in the Leytonstone area of London. The practice is a part of Waltham Forest Clinical Commissioning Group (CCG) and provides NHS primary medical services through a Personal Medical Services (PMS) contract (a locally agreed alternative to the standard GMS contract used when services are agreed locally with a practice which may include additional services beyond the standard contract).

The population served by the practice is an inner-city deprived area with high rates of deprivation. The practice has a larger number of patients aged 25 to 39 than the CCG and national average and 58% of the practice population has a long standing health condition, which is higher than the CCG average of 47% and the national average of 53%.

The practice is staffed by one female GP partner and a male sessional GP who complete a total of 18 sessions per week; there is also a female practice nurse who completes five sessions per week. Other staff members include a practice manager partner, an assistant practice manager and five reception/administration staff members.

The practice is open Monday to Friday between 9am and 6:30pm except for Fridays when the practice opens at 8:30am and Thursdays when the practice closes at 2pm. Phone lines are answered from 9am to 12:30pm and 2:30pm to 6:30pm, the locally agreed out of hours provider covers calls made to the practice when it is closed. Appointment times are as follows:

• Monday 9am to 10:50am and 4pm to 6:20pm.

• Tuesday 9am to 10:50am and 4pm to 6:20pm.

• Wednesday 9am to 10:50am and 4pm to 6:20pm.

• Thursday 9am to 2pm.

• Friday 9am to 10:50am and 4pm to 6:20pm.

Thatched House Medical Centre operates regulated activities from one location and is registered with the Care Quality Commission to provide diagnostic and screening procedures, treatment of disease, disorder or injury and maternity and midwifery services.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Overall inspection

Good

Updated 7 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Thatched House Medical Centre on 22 June 2016. The overall rating for the practice was requires improvement. The full comprehensive report published in September 2016 Month can be found by selecting the ‘all reports’ link for Thatched House Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced follow up inspection on 28 April 2017 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 on 22 June 2016. There were breaches in infection control and governance procedures. There were also concerns with the training of staff members, significant event processes, Quality Outcomes Framework exception reporting levels, there being no hearing loop in the premises and the lack of extended hours appointments. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.Overall the practice is now rated as good.

Our key findings were as follows:

• There was an up to date infection control audit and legionella risk assessment and the practice had carried out the actions identified as a result.

• Recruitment arrangements for newly appointed staff members followed national guidance; staff members had the appropriate checks including Disclosure and Barring Service checks carried out prior to employment.

• The practice had a clear vision and a strategy to deliver it; the vision was emailed to all staff members and displayed around the practice for staff and patients to see.

• All staff members had access to an online training portal and had completed all mandatory training and training relevant to their roles, this included chaperone training, fire training and infection control training. All staff had an appraisal documented in their record in the past 12 months.

• Significant events was standing agenda item at practice meetings, there were systems in place to analyse and identify themes from significant events and take appropriate action.

• The practice had disabled facilities including a hearing loop.

• The practice was a part of the local HUB which provided GP appointments to their patients on weekends and when the practice was closed, the GP also worked at the HUB and patients knew the days when she was on duty. There were telephone consultations each day at the end of GP sessions including in the evening.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice