Wood Street Health Centre in London is a Doctors/GP specialising in the provision of services relating to caring for adults over 65 yrs, caring for adults under 65 yrs, diagnostic and screening procedures, family planning services, maternity and midwifery services, services for everyone and treatment of disease, disorder or injury. The last inspection date here was 5th December 2019
Wood Street Health Centre is managed by Waltham Forest Community And Family Health Services Limited.
Contact Details:
Address:
Wood Street Health Centre 6 Linford Road London E17 3LA United Kingdom
We previously carried out an announced comprehensive inspection of Wood Street Health Centre on 24 January 2019 and found the practice was in breach of Regulation 12: ‘Safe care and treatment’ and Regulation 17: ‘Good governance’ of the Health and Social Care Act 2008. In line with the Care Quality Commission’s (CQC) enforcement processes, we issued two warning notices which required Wood Street Health Centre to comply with the Regulations by 12 April 2019.
The full report of the 24 January 2019 comprehensive inspection can be found by selecting the ‘all reports’ link for Wood Street Health Centre on our website at www.cqc.org.uk.
We carried out this announced focused inspection on 25 April 2019 to check whether the practice had addressed the issues in the warning notices and now met the legal requirements. This report covers our findings in relation to those requirements and does not change the current ratings held by the practice.
At the inspection on 25 April 2019 we found the provider had taken action to address the requirements of the warning notices, although they were still in the process of addressing patient feedback about access to care.
Our key findings were as follows:
Safeguarding policies and information posters had been reviewed and updated.
Disclosure and Barring Service (DBS) checks were undertaken for all staff.
There was evidence that the practice carried out appropriate recruitment, professional registration and indemnity checks.
There was improved assessment and oversight of potential risks at both sites, including health and safety, fire safety, legionella and infection control.
The practice had put in place processes to manage risks relating to test results and high risk medicines and had acted appropriately in response to findings from the previous inspection around outstanding results and instances of unsafe prescribing.
There was oversight of the pharmacist and policies to cover any changes to patients’ medicines.
There was a defibrillator at the branch site for use in an emergency and evidence of regular checks to ensure it was in good working order.
The practice was effectively monitoring the refrigerator temperature at the branch site.
The systems to review, record and act upon safety alerts and significant events were effective.
The practice had improved oversight of the branch site through senior staff attending on a regular basis and manual transfer of updated policies and procedures from the main practice to the branch.
Mandatory training had been completed by staff, including basic life support, fire safety, child and adult safeguarding, information governance and infection control training.
The practice manager had received an appraisal by the lead GP.
On the day of inspection there was no formalised action plan in place to address issues around access, although low GPPS results were due to be discussed as a full practice team and some measures had been put in place to improve access for patients.
Although there were no breaches of Regulations, we identified areas where the provider should make improvements:
Consider the necessity for fire wardens to complete specific fire warden training.
Ensure review dates are included on all policies and relevant information posters.
Implement a formal action plan to improve access for patients and monitor progress.
Ensure effective communication with building landlords to enable oversight of any risks relating to premises.
Details of our findings and the evidence supporting our ratings are set out in the evidence table.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care
We carried out an announced comprehensive inspection of Wood Street Health Centre on 24 January 2019 as part of our inspection programme.
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 inadequate overall.
We rated the practice as inadequate for providing safe services because:
The practice did not have effective systems for the appropriate and safe use of medicines as we found evidence of unsafe prescribing of high risk medicines, there was no defibrillator at the branch site for use in an emergency and we identified concerns in relation to the effective monitoring of the refrigerator temperature.
We identified 50 outstanding test results on the clinical system which the practice was not aware of, which may have left patients untreated.
There was no written protocol or risk assessment for the pharmacist in relation to making changes to patients' medicines which identifies when GPs should be involved or consulted.
No infection control audits had been completed at the main practice since April 2016 and at the branch site since February 2014 to ensure appropriate standards of hygiene were maintained and monitored.
The practice had not completed its own risk assessments, such as fire, legionella or health and safety, to ensure premises were safe.
No Disclosure and Barring Service (DBS) checks were carried out for non-clinical staff members, including those who acted as chaperones, and no risk assessment had been carried out at the time of inspection to support this decision.
There were gaps in staff recruitment checks and ineffective systems for ongoing staff checks relating to registration and indemnity insurance.
The system for recording and actioning safety alerts was not effective.
We rated the practice as inadequate for providing responsive services because:
Patients were not able to access care and treatment in a timely way.
The practice’s GP patient survey (GPPS) results were below local and national averages for questions relating to access to care and treatment, and these results mirrored those of the practice’s own assessment questionnaire carried out in December 2018.
Negative patient feedback about access had been identified as a concern at a previous CQC inspection in August 2016. Low GPPS results had not been discussed with staff and there was no action plan in place to address negative feedback and improve access for all patients.
These areas affected all population groups, so we rated all population groups as inadequate for responsive services.
We rated the practice as inadequate for providing well-led services because:
The provider had no oversight of any risk assessments completed by other parties to ensure the premises were safe, or any oversight of whether identified risks had been addressed.
There was a lack of oversight of activities and governance at the branch site and ineffective communication between the main practice site and branch site.
The practice did not have effective policies and processes in relation to safeguarding.
There was no effective oversight or monitoring of staff training and we identified gaps in training.
Significant events and complaints were recorded, however there was no formalised system to share learning with all relevant staff to ensure changes or improvements were effectively implemented.
We rated the practice as requires improvement for effective services because:
Patients’ needs were not consistently assessed, and care and treatment was not always delivered in line with current legislation, standards and evidence-based guidance.
The systems to monitor and assess staff performance were ineffective.
The practice was unable to demonstrate that it always obtained consent to care and treatment in line with legislation and guidance, as consent was not documented.
These areas affected all population groups, so we rated all population groups as requires improvement for effective services.
We rated the practice as good for providing caring services because:
Feedback from patients was generally positive about the way staff treated people.
The practice respected patients’ privacy and dignity.
The areas where the provider must make improvements 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).
The areas where the provider should make improvements are:
Consider measures to encourage the uptake of childhood immunisation and cervical screening rates.
Review the processes for recording and monitoring of consent.
Ensure there is an effective system in place to keep clinicians up to date with current evidence-based guidelines.
I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.
Special measures will give people who use the service the reassurance that the care they get should improve.
Details of our findings and the evidence supporting our ratings are set out in the evidence table.
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Wood Street Health Centre on 04 August 2016. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
National GP patient survey results showed patients did not always feel they were treated with compassion, dignity and respect. However the practice was taking effective action to improve patients’ experience of the caring aspects of care.
Patients found it difficult to access the service. The provider was taking action to improve the responsiveness of the service, with some success for example around telephone access to the practice, however performance remained below average.
There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
Risks to patients were assessed and well managed.
Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
The practice had good facilities and was well equipped to treat patients and meet their needs.
There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
The provider was aware of and complied with the requirements of the duty of candour.
The areas where the provider must make improvement are:
Ensure care and treatment are provided in a safe way for patients.
The areas where the provider should make improvement are:
Keep under review and continue to build on its success on improving patients’ experience of the caring aspect of the services provided, in particular consultations with nurses.
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Wood Street Health Centre on 4 August 2016. The overall rating for the practice in the report published on 8 March 2017 was good but specifically requiring improvement in the provision of responsive services. This led to the issuing of a requirement notice being served in that the care and treatment of patients was not provided in a safe way. Patients found it difficult to get through to the practice on the phone and to get a timely appointment to be seen. This was in breach of regulation 12(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Wood Street Health Centre on our website at www.cqc.org.uk.
This inspection was an announced focused inspection carried out on 16 August 2017 to check that improvements had been made since our previous inspection on 4 August 2016. This report covers our findings in relation to those improvements made since our last inspection.
Overall the practice is rated as good and the provision of responsive services is now also rated as good.
Our key findings were as follows:
The practice was able to show that significant work had been undertaken in the introduction of changes enabling it to be more responsive to the needs of patients.
Access to the practice and the availability of appointments had improved.
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