Background to this inspection
Updated
25 November 2019
St John’s Medical Centre is situated at St John’s Road, Altrincham, Cheshire, WA14 2NW. The surgery has good transport links and there is a pharmacy located nearby.
The provider is registered with CQC to deliver the Regulated Activities diagnostic and screening procedures, maternity and midwifery services, family planning, treatment of disease, disorder or injury and surgical procedures.
The practice delivers primary care under a General Medical Services contract between themselves and NHS England. As part of Trafford Clinical Commissioning Group (CCG) they are responsible for a population of approximately 17,000 patients within the surrounding areas of Dunham Massey, Broadheath, Hale and Bowden. The practice is fully computerised and registered under the Data Protection Act 1984. They are also affiliated to eleven surrounding residential and care homes.
There is a mixed gender of 11 GPs, a practice manager and a team of nurses and health care assistants. There are also several reception and administration staff. This is a training practice and offers appointments to patients with trainee GPs who are clinically monitored.
The practice population is mainly white british with less than 10% diversity and the area is situated in the lowest level of deprivation based on levels between one and ten, with ten being the least deprived. In England people living in the least deprived areas of the country live around 20 years longer in good health than people in the most deprived areas. Approximately one third of the patients registered at this practice was over the age of 65.
Updated
25 November 2019
This practice was originally inspected in January 2015 when they were rated good overall. On 4 February 2019 we undertook an announced comprehensive inspection as part of our inspection programme. At that inspection we rated the practice good overall but requires improvement in Safe.
We rated the practice as Requires Improvement for providing safe services because there were gaps in systems to assess, monitor and manage risks to patient safety. For example, failsafe monitoring of high risk drugs was not taking place, not all vulnerable adults were highlighted within the system, there were fire safety issues in an outside building, consultations of medication reviews were not consistent, and there was some high data exception reporting.
The concerns we found amounted to a breach of Regulation 12 of the Health and Social Care Act 2014 (Safe Care and Treatment) and we told the practice that they must ensure care and treatment is provided in a safe way to patients.
Following the inspection, the partners discussed the identified issues and put in place a plan to address the concerns imminently. They also sent in new protocols and policies to assure us that our concerns were being addressed.
We carried out a desk top focused review of St John’s Medical Practice following our annual review of the information available to us, including information provided by the practice. Our review indicated that there had been a significant improvement to the quality of care provided in the Safe domain.
The desk top review focused on those areas within the key question SAFE. The practice has submitted to CQC, a range of documents which demonstrate they are now meeting the requirements of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. On review of the information provided by the practice we found they were good in providing safe services.
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.
Overall, the practice continues to be rated as good.
We have rated the safe domain as Good because:
- High risk drugs were being appropriately monitored.
- Vulnerable patients were being appropriately highlighted within the clinical system.
- Fire safety in an outside building had been assessed.
- Consultations following medicine reviews were being consistently documented.
- Risk assessments were in place for emergency medicines.
- Exception reporting was no longer high.
- All staff were involved in incident reporting and review.
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