Archived: The Maples Health Centre

Updated 20 December 2019

• The Maples Health Centre extended access service is provided by Lea Valley Health Limited. The registered manager is A Sattar. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
• The registered address of The Maples Health Centre is Vancouver Road, Broxbourne, Hertfordshire, EN10 6FD. The provider is in the process of changing the registered address to The Limes Surgery, 8-14 Limes Court, Conduit Lane, Hoddesdon, Hertfordshire, EN11 8EP.
• The website address is www.leavalleyhealth.co.uk.
• The service is registered with the CQC to provide the following regulated activity:

• Treatment of disease, disorder or injury.

• The Maples Health Centre provides a GP extended access service to patients registered with the eight NHS GP practices within the Lower Lea Valley locality.
• Appointments are available from 6:30pm to 8pm Monday to Friday and from 9am to 1pm on Saturdays and Sundays. The service is delivered across six different premises.
• Lea Valley Health Ltd is made up of five company directors. The day to day management of the extended access is overseen by a service manager who works alongside the practice manager of each site where the service is provided from during weekdays.

How we inspected this service

Our inspection team was led by a CQC lead inspector and included a GP specialist adviser.

Before our inspection, we gathered and reviewed information from the local Clinical Commissioning Group, the pre-inspection return submitted by the provider and patient feedback submitted online.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 20 December 2019

This service is rated as Requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection at The Maples Health Centre (extended access service only) as part of our inspection programme.

The extended access service (registered as The Maples Health Centre) is provided by Lea Valley Health Limited. Lea Valley Health is a federation of eight NHS affiliated GP Practices and serves approximately 76,000 patients in Lower Lea Valley, Hertfordshire.

The service provides a GP extended access service to patients registered with one of the eight NHS GP practices within the Lower Lea Valley locality. The service commenced on 17 September 2018.

Each practice has been allocated a number of appointments per week which can be directly booked into the extended access service. Appointments are available from 6:30pm to 8pm Monday to Friday and from 9am to 1pm on weekends. The service is available to patients of all ages under the terms of an Alternative Provider Medical Services (APMS) contract with the local Clinical Commissioning Group (CCG). APMS is a contract with the CCG for delivering primary care services to local communities.

The extended access service operates from six different premises within the locality and is available 365 days a year including bank holidays.

Mondays: Stanhope Surgery, Stanhope Road, Waltham Cross, EN8 7DJ.

Valley View Health Centre, Goffs Lane, Goff Oak, EN7 5ET.

Tuesdays: Stockwell Lodge Medical Centre, Rosedale Way, Cheshunt, EN7 6HL.

Wednesdays: Stanhope Surgery, Stanhope Road, Waltham Cross, EN8 7DJ.

Thursdays: Cromwell Medical Centre, 11 Cromwell Avenue, Cheshunt, EN7 5DL.

Fridays: Warden Lodge Medical Practice Glen Luce, Turners Hill, Cheshunt, EN8 8NW.

Weekends: Cheshunt Community Hospital, King Arthur Court, Waltham Cross, EN8 8XN.

Our key findings were:

• The service did not have clear systems to keep people safe and safeguarded from abuse in all areas.
• The service did not have clear oversight of safety risk assessments and checks, such as health and safety, infection prevention and control, fire safety and Legionella.
• Staff had the information they needed to deliver safe care and treatment to patients.
• The service did not have reliable systems for appropriate and safe handling of medicines.
• The system in place to ensure learning from significant events and safety alerts was not comprehensive.
• The service was able to demonstrate how staff had the skills, knowledge and experience to carry out their roles.
• Patient feedback demonstrated that staff treated people with compassion, kindness, dignity and respect.
• Patient feedback demonstrated that they were able to access care and treatment from the service within an appropriate timescale for their needs.
• Structures, processes and systems to support good governance and management were not clearly set out, understood and effective.

The areas where the provider must make improvements as they are in breach of a regulation 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.

Please see the specific details on action required at the end of this report.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care