27 June 2022
During a routine inspection
We carried out an announced inspection at Knutsford Medical Partnership on 22, 23, 24 and 27 June 2022. Overall, the practice is rated as Good.
The ratings for each key question are: -
Safe - Good
Effective - Good
Caring – Good
Responsive - Outstanding
Well-led - Good
Knutsford Medical Partnership was registered with the Care Quality Commission (CQC) with the merger of three separate GP practices (locations) in April 2020. The three separate locations were previously inspected by CQC. Annandale Medical Centre on 4 May 2016 and was rated Good. Manchester Road Medical Centre on 14 March 2019 and was rated Good. Toft Road Surgery on 7 March 2019 and was rated Requires Improvement. Toft Road Surgery was rated Requires Improvement as improvements were needed to how the service safeguarded patients and to the systems to ensure safe care and treatment and good governance.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Annandale Medical Centre, Manchester Road Medical Centre and Toft Road Surgery on our website at www.cqc.org.uk
Why we carried out this inspection
We carried out this inspection as Knutsford Medical Partnership was one of several services identified to be inspected to test our rating methodology. This service had also not been inspected since the change in registered provider and we needed to follow-up the actions we told the provider to take to improve the service at Toft Road Surgery. This inspection was a comprehensive review of information which included a site visit.
This review assessed the following key questions: -
Safe
Effective
Caring
Responsive
Well-led
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 with consent from the provider and in line with all data protection and information governance requirements.
This included:
- Conducting staff interviews using video conferencing
- Completing clinical searches on the practice’s patient records system and discussing findings with the provider
- Reviewing patient records to identify issues and clarify actions taken by the provider
- Requesting evidence from the provider
- A short site visit to two of the provider’s locations
- A site visit to the dispensary
Our findings
We based our judgement of the quality of care at this service 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.
We have rated this practice as Good overall and Outstanding in providing Responsive services.
We found that:
- The provider had made improvements at Toft Road Surgery to address the issues we had identified at the inspection on 7 March 2019. Improvements had been made to the management of patient’s medication, systems to safeguard patients and to the governance of the service.
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs.
- Staff had access to the training and support they needed for their roles.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
- Patients could access care and treatment in a timely way, and they had a choice of access to meet their needs.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
- The provider could demonstrate they had made changes to the practice as a result of listening to staff and patients.
- The provider was innovative and was involved in a number of projects to promote the health and well-being of patients and staff.
- The provider reviewed the service provided and had clear plans in place to ensure continuous improvements were made.
The provider was rated outstanding for providing responsive services. This was because: -
- People’s individual needs and preferences were central to the delivery of tailored services.
- There were innovative approaches to providing integrated person-centred pathways of care that involved other service providers, particularly for people with multiple and complex needs.
- The services were flexible and promoted continuity of care.
- The provider demonstrated that it took part in a range of activities to meet the needs of its patient population. In order to meet the needs of a large elderly population the provider held multi-disciplinary meetings, daily virtual ward rounds and provided a visiting service to coordinate patient care and treatment and to prevent a patient being admitted to hospital where possible. The provider was involved in a range of quality improvement initiatives to improve patient care. The provider was the lead organisation for the implementation of the Complete Community Care Programme which was a national project which focused on reducing health inequalities. This group (Knutsford Care Community) included the voluntary sector, social care, Patient Participation Group (PPG) and community services. The group were involved in a range of initiatives such as revising the dementia pathway, trialing a Leg Club, virtual clinics to provide quicker support to patients where possible and the group had established a Monday Club for people who were isolated.
We also identified other elements of outstanding practice: -
- Leadership strategies were in place to ensure and sustain delivery and to develop the desired culture. The provider had several methods of communicating with the staff team including a network of meetings, emails and newsletters. The provider engaged with staff when developing the service and making changes. The provider had also developed a system of support to promote the well-being of the staff team.
Whilst we found no breaches of regulations, the provider should:
- Carry out a programme of improvement for the premises.
- Carry out regular checks of the premises to identify any infection control or building security issues.
- Introduce a system to formally document the monitoring of consultations, referrals and prescribing of clinicians.
- Look at providing more patients with steroid cards (helps healthcare staff identify and treat patients with adrenal insufficiency).
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care