Isleworth Medical Centre

We carried out an announced inspection at Isleworth Medical Centre, with the remote clinical searches on 6 January 2023 and site visit on 11 January 2023. This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

Following our previous inspection on 13 December 2017, the practice was rated good overall and for all key questions.

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

Why we carried out this inspection

We carried out this inspection in response to concerns raised with us.

This was a comprehensive inspection focusing on whether:

• Care and treatment was being provided in a safe way to patients.
• There were effective systems and processes in place to ensure good governance in accordance with the fundamental standards of care.

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.
• 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.

We have rated this practice as Good overall.

We have rated this practice as Good for providing safe services because:

• The practice had clear systems, practices and processes to keep people safe from abuse.
• The practice held regular internal and multidisciplinary team meetings to discuss the care of patients, including safeguarding concerns and care of vulnerable patients.
• The premises were well managed and there were effective systems for the management of infection prevention and control.
• Emergency medicines on site were organised, in date and effectively managed.
• The practice had appropriate systems for the safe use of medicines, including medicines optimisation.
• Medication reviews were completed appropriately.
• The practice had effective processes for managing patient safety alerts.

We have rated this practice as Good for providing effective services because:

• The practice had effective systems for the management of long-term conditions.
• The practice’s uptake for cervical screening was lower than the 80% coverage target for the national screening programme. The practice had not met the 90% update for all of the childhood immunisations indicators, or the WHO based national target of 95%. The practice had put in place systems to address barriers to the uptake of cervical screening and childhood immunisations and was working towards improving uptake.
• The practice had worked towards providing effective care for patients during the Covid-19 pandemic.
• The practice had a comprehensive programme of quality improvement activity.

We have rated this practice as Good for providing caring services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice had arrangements for providing interpreters for patients who did not have English as a first language and made adjustments for patients to ensure access.
• The practice offered longer appointments for patients with complex needs and patients with vulnerable circumstances.

We have rated this practice as Good for providing responsive services because:

• We found that patients’ needs were met through the way services were organised and delivered.
• The practice analysed the national GP survey and conducted its own comprehensive local survey, which it had analysed and put in place improvements to the service where possible. These included the installation of a new telephone system, ensuring more appointments were available on the day and on future dates, longer appointments where appropriate, fast track access for older patients, and increasing capacity of appointments.

We have rated this practice as Good for providing well-led services because:

• The practice analysed and understood the needs of its practice population. The leadership was knowledgeable about issues and priorities for the quality and sustainability of services, understood what the challenges were and acted to address them.
• There was a clear statement of vision and values, driven by quality and sustainability.
• The practice actively sought feedback from staff members, encouraged engagement and promoted staff wellbeing.
• The practice had a governance framework in place and was effectively managing risks.
• The practice encouraged personal development and learning amongst staff and was supportive in staff undertaking appropriate learning for their roles and in their future aspirations.
• Staff members spoke positively about their employment at the practice and felt supported.

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

• Continue to monitor and action patient safety alerts. Continue to address risks in relation to use of teratogenic medicines (medicines which are known or are suspected to have the potential to increase the risk of birth defects and development disorders) for female patients of childbearing age.
• Continue to address the barriers to childhood immunisations and cervical screening and increase uptake.
• Continue to analyse patient feedback and improve access to the service.
• Improve engagement with the patient participation group (PPG).

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 Hospitals and Interim Chief Inspector of Primary Medical Services