Wakering Medical Centre

Updated 11 July 2023

Wakering Medical Centre is located in Great Wakering at:

274, High Street

Great Wakering

Essex

SS3 0HX

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

The practice is situated within the Mid and South Essex Integrated Care System (ICS) and delivers General Medical Services to a patient population of about 10,500. This is part of a contract held with NHS England.

The practice is part of Rochford District Primary Care Network, (PCN), which comprises 6 individual GP practices.

The practice is situated within the Mid and South Essex Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 10,500.

The practice also has a dispensary on site.

Information published by Public Health England shows that deprivation within the practice population group is in the eighth lowest decile (eight of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 96.2% White, 1.8% Asian, 0.7% Black, 1.3% Mixed.

There is a team of three GP partners and a salaried GP. The practice has a team of two nurses and a healthcare assistant. There are three dispensers. The GPs are supported at the practice by a team of reception, administration and secretarial staff led by a practice manager.

The practice is open between 8am and 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided locally by a local GP surgery, where late evening and weekend appointments are available. Out of hours services are accessed through NHS 111.

Updated 11 July 2023

We carried out an announced comprehensive/focused inspection) at Wakering Medical Centre on 31 May 2023. Overall, the practice is rated Good.

Safe - Good

Effective – Good

Caring – Good

Responsive – Good

Well-led - Good

Following our previous inspection on on 4 August 2022 and 23 August 2022, the practice was rated inadequate overall. We rated safe as inadequate, effective as requires improvement, caring as good, responsive as requires improvement, and well-led as inadequate.

The practice was served a warning notice and placed in special measures.

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

Why we carried out this inspection

We carried out this inspection to follow up on the warning notice served following the previous inspection, the breaches of regulations 12 and 17, the rating of inadequate overall, and the inadequate ratings for the key questions, safe, and well-led.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing and in person.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• 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.

At the previous inspection we found:

• The practice did not have an effective system in place to review children and adults with safeguarding concerns.
• There was not an effective system in place to manage incoming correspondence on the clinical system and unplanned hospital admissions were not reviewed.
• Systems for the safe management of medicines were not effective. We found out of date emergency medicines, patients prescribed high risk medicines were not appropriately monitored, the process for managing requests for repeat prescriptions was not effective and there was no established system for recording and acting on medicines and patient safety alerts.
• There were no systems in place for recruitment checks, vaccination checks, staff appraisals, staff training to assist them in identifying medical emergencies, and procedures to support and manage staff with poor performance.
• We saw limited evidence that the practice had carried out any clinical quality improvement activity and there were no effective systems in place to regularly review data to improve performance.
• There was no system to record or update the competence of staff employed in clinical practice and there was no system to ensure the competence of staff who worked at the practice who were employed by the primary care network (PCN).
• People with long term conditions had not received the care and treatment required.
• The practice had a clear vision, but it was not supported by a credible strategy to provide high quality sustainable care.

At this inspection we found:

• All of the concerns from the previous inspection had been adequately adressed and there were no longer any breaches of regulations.
• 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 dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Ensure that any monitoring carried out by secondary or community service is clearly visible on the patient record, without the need to access an additional system.
• Continue to monitor the number of prescriptions for broad-spectrum antibiotics, reducing the number prescribed where it is possible to do so.
• Coninue to monitor the prescribing of medication for uncomplicated urinary tract infections, working with colleagues insecondary care services to reduce the number prescribed where it is possible to do so.
• Continue to improve the uptake of cervical screening.

I am taking this service out of special measures. This recognises the improvements that have been made to the quality of care provided by this service.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care