Archived: Great Chapel Street Medical Centre

We carried out an announced inspection at Great Chapel Street Medical Centre on the 8th, 12th and 13th of October 2021. Overall, the practice is rated as Good.

Set out the ratings for each key question

Safe - Good

Effective - Good

Caring - Good

Responsive - Outstanding

Well-led – Good

Following our previous inspection on 11 January 2018, the practice was rated good overall and for all key questions and outstanding for responsive:

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Great Chapel Street Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a comprehensive inspection to follow up on a change in ownership of the practice, looking at whether they were:

• 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

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 for providing responsive services.

We found that:

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• All staff received up-to-date safeguarding and safety training appropriate to their role. They knew how to identify and report concerns.
• Staff who acted as chaperones were trained for the role and had received a DBS check, and posters advertising this were in the waiting room and consulting rooms.
• The practice conducted safety risk assessments. It had a suite of safety policies which were regularly reviewed and communicated to staff. Staff received training in basic life support, sepsis and fire safety.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The waiting room was in need of decorating and the flooring needed replacing; however, the service would be moving to a new location in 2022 which would be fully compliant.

We saw several areas of outstanding practice:

• The practice provided an outreach service out of hours in which the practice nurse would access homeless shelters and search for homeless people on the street to reach people with complex needs who may find it difficult to engage with health and social care providers. As a result of the pandemic the services patient group had been moved in to hostels and hotels the practice responded to this by expanding their outreach programme to seeing their patients in these locations to help reduce the health inequalities that this patient group would have suffered at this time.

• The practice supplied the hostels and hotels with tablets so that patients could have remote consultations and also mobile phones to remind patients of appointments, medication reviews and telephone consultations.

• The practice worked with third sector organisations to ensure that their patients had assistance with job applications, represented patients at court hearings in relation to benefits sanctions and liaised with re-housing services to access temporary or permanent accommodation for patients.

• Practice staff provided training for staff working in other organisations for the homeless such as hostels in relation to monitoring of medicines and management of aggression. They also provided support and training for the 8 other borough’s in North West London.

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