This practice is rated as Good overall. (Previous rating August 2015- Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Broadway Medical Centre on 10 October 2018 as part of our annual programme of inspection.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice recorded and investigated them, however learning from these was not always shared effectively.
• 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.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that 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.

We saw several areas of outstanding practice :-

• The practice delivered a mental health service jointly with another practice in Fleetwood Neighbourhood team. Patients were triaged within three days and 98% received low intensity cognitive behavioural therapy within two weeks.
• The practice had set up a specialist Hepatitis C clinic in conjunction with Fleetwood Neighbourhood team to address local needs in relation to substance abuse.
• A practice paramedic was employed who carried out home visits for patients with acute problems, they could admit directly to hospital when required. This member of staff also led on end of life care maintaining contact with bereaved families to provide ongoing support and signposting.
• The practice had carried out five initiatives in the past two years to gain feedback on services and facilities. This included a carers event in conjunction with the local carers service.

The areas where the provider should make improvements are:

• Improve the documentation of incidents to ensure that actions agreed and learning outcomes are clearly recorded and reviewed.
• Update the recruitment policy to include reference to the use of DBS checks for clinical staff and chaperones.
• Take action so that uncollected prescriptions are managed efficiently.
• Review recall systems in order to improve attendance of patients with long term conditions
• Continue to take action to identify patients with caring responsibilities.
• Consider adding a hearing loop to improve the experience of patients with hearing impairment.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information

Letter from the Chief Inspector of General Practice

This is a focused desk top review of evidence supplied by Broadway Medical Centre for one area only, Medicines Management within the key question safe

We found the practice to be good in providing safe services. Overall, the practice is rated as good.

Broadway Medical Centre was inspected on 10 December 2014. The inspection was a comprehensive inspection under the Health and Social Care Act 2008. At that inspection, the practice was rated ‘good’ overall. However, within the key question safe, medicines management was identified as ‘requires improvement’, as the practice was not meeting the legislation in place at that time; (Regulation 13 Medicines Management of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010).

At the inspection in December 2014 we found that medicines were not stored as required and record keeping was poor.

The practice supplied an action plan with timescales telling us how they would ensure they met Regulation 13 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2010 (HSCA 2008).

The practice has submitted to CQC, a range of documents which demonstrate they are now meeting the requirements of the new legislation that has superseded the Health & Social Care Act 2008 (Regulated Activities) Regulations 2010; Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe and Care Treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Broadway Medical Centre.

We carried out a comprehensive inspection on 10 December 2014. We spoke with patients, members of the Patient Participation Group (PPG) and staff, including the management team.

The practice was rated as good overall.

Our key findings were as follows:

• All staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. 
• National Institute for Health and Care Excellence (NICE) guidance was used routinely. Patients’ needs were assessed and care planned and delivered in line with current legislation.
• We received mixed views about the availability of appointments at the practice. Patients told us they could access urgent appointments when they needed to, but often had to wait up to two weeks to see a doctor of their choice. The practice had increased the amount of ‘book on the day’ appointments in order to meet patient demand.
• The practice was clean and accessible to patients with a physical disability. Improvements had been identified as part of a recent audit and survey.
• The practice took time to listen to the views of their patients and ran an active Patient Participation Group. Actions were identified and taken to improve the service.

• The practice was responsive to the needs of its patients with dementia. Three members of staff were to attend dementia friends training as well as the staff team to conduct e-learning on this subject. A Nurse Practitioner had been recruited who led on Dementia Care and provided health reviews for those patients who were housebound.

There were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure medicines are managed effectively, by means of appropriate arrangements for the recording and safe keeping of medicines. The provider is failing to meet regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

In addition the provider should:

• Notify the Care Quality Commission of all relevant incidents as required under the Health and Social Care Act 2008(Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009 
• Review significant incident procedures to ensure learning is identified, actioned and reviewed appropriately.

Ensure that staff are recruited and employed safely. The necessity to conduct criminal record checks for non clinical staff should be appropriately risk assessed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice