Background to this inspection
Updated
19 October 2020
Warders Medical Centre is located at East Street, Tonbridge, Kent, TN9 1LA. The practice is located in two buildings, one a converted house and the other a converted bungalow. A branch surgery is located at The Village Hall, Penshurst, Kent, TN11 8BP.
The practice building is arranged over three storeys, with all the patient accessible areas being located on the ground floor. Additionally, there is a ground floor level building a short distance from the main practice, known to staff and patients as ‘Little Warders’, where patient consultations, out of hours services and a private travel clinic is operated from.
At Penshurst Surgery, the practice building is arranged over two storeys, with all the patient accessible areas being located on the ground floor. The practices are accessible to patients with mobility issues, as well as parents with children and babies. Penshurst Surgery is able to provide dispensary services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy premises.
The provider is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury, Diagnostic and screening procedures, Maternity and midwifery services and Surgical procedures.
Warders Medical Centre is situated in a suburban area of the Kent and Medway Clinical Commissioning Group (CCG) and provides services to 18,487 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.
The practice staff consists of nine GP partners (male and female), three female salaried GPs and two (male/female) GP registrars. There were four female practice nurses and two healthcare assistants and a team of dispensers. There was a practice manager, an assistant practice manager and a team of reception and administrative staff. The practice is a training practice which hosts medical students, foundation year two students and GP Registrars (ST1 – ST3). The practice is part of a wider network of GP practices (a federation) West Kent Health.
The practice is in one of the least deprived areas of Kent. A higher than average proportion of patients are in work or full-time education and there is less unemployment among the practice population. There is a higher proportion of patients under the age of 18 and a marginally higher proportion of patients over the age of 75. Life expectancy is higher than average, for men it is 81 years compared with the national average of 79 years and for women it is 86 years compared with the national average of 83 years. There is a significantly smaller proportion of patients living with a long-standing health condition.
Updated
19 October 2020
We carried out an announced comprehensive inspection at Warders Medical Centre on 3 December 2019. The practice was rated as Good overall and rated as Requires Improvement for providing safe services and Good for providing effective, caring, responsive and well-led services. Breaches of regulation were identified.
We rated the practice as requires improvement for providing safe services because:
- Patients on high-risk medicines were not always monitored appropriately.
- Safety alerts were not always acted on.
- Staff were not aware of practice access/storage of midazolam for emergency treatment of seizures.
- Medicine and prescription security were insufficient.
- Disclosure and barring service checks were not always conducted on relevant staff before they commenced in post.
- There were gaps in safeguarding and infection control training.
We undertook this desk based follow-up review on 5 October 2020, as part of our inspection programme and to check the practice had met the regulatory requirements, as well as followed their own action plan to ensure safe services were being provided. Based on the documentary and photographic evidence provided, we have rated the practice as Good for providing safe services.
We also checked that the provider had continued to ensure they had acted to address the areas where we told them they should make improvements. The provider sent us documentary evidence to confirm that since our inspection in December 2019, the practice had:
- Continued to make improvements to ensure that the DBS protocol was embedded, and that all new staff are recruited with a DBS check or risk assessment in place.
- Continued to make improvements to ensure that fire drill records were appropriately maintained. Documentary evidence provided from the practice and Kent and Medway Fire and Rescue services confirmed this.
- Continued to make improvements to ensure that staff vaccination records were up to date, and all necessary action had been taken, where required. The system for routine checking is now fully embedded.
- Continued to make improvements to ensure that uptake rates for childhood immunisations increased. However, these methods were subsequently halted during the COVID-19 pandemic, which influenced the uptake rates.
- Continued to make improvements to ensure that cervical screening recalls and methods for engaging with hard to reach patients had been improved. However, these methods were subsequently halted during the COVID-19 pandemic.
You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Warders Medical Centre on our website at .
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Bennyworth BS BMedSci MRCGP
Chief Inspector of General Practice