• Doctor
  • Independent doctor

Archived: Poland Medical

Overall: Requires improvement read more about inspection ratings

364A Whitton Avenue East, Greenford, Middlesex, UB6 0JP (020) 8903 4874

Provided and run by:
Poland Medical LLP

Important: We are carrying out a review of quality at Poland Medical. We will publish a report when our review is complete. Find out more about our inspection reports.

All Inspections

27 February 2023

During a routine inspection

This service is rated as Requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Inadequate

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

Poland Medical provides an independent doctor service and is based in Greenford, outer West London. The service has a Registered Manager. A Registered Manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We carried out an announced comprehensive inspection at Poland Medical on 27 February 2023 as part of our inspection programme.

Our key findings were:

  • Individual care records were not written in a way that kept patients safe. For example, our review of a selection of patient records highlighted an absence of examination findings or of evidence that patients had been advised on actions to take if their condition worsened changed or failed to improve. This presented a risk to patients in that records contained insufficient information to either support diagnoses or enable other health care professionals to understand and interpret clinical decision making.
  • The provider had not ensured they had all the details of the patient’s health from their NHS GP prior to starting treatment which meant there was a risk they were not aware of all relevant healthcare needs. We noted they did gain patient’s consent to share details of treatment with their NHS GP.
  • Patient records did not always include the necessary details of prescribed medication including frequency, duration and quantity.
  • From November to December 2022 there had been three recorded incidents of prescription fraud. Although the service recorded significant incidents, staff did not carry out a root cause analysis, to support shared learning and minimise chance of recurrence. At the time of the inspection whilst prescription pads were being stored securely, individual prescriptions were not being monitored.
  • Risks associated with infection prevention and control were not all being regularly checked (for example regarding a bacterium called Legionella which can proliferate in building water systems).
  • Issues to do with patient safety, incidents and complaints were discussed at team meetings. However, most staff could not attend the meeting and relied on reading meeting minutes to identify learning. These minutes were very brief and did not contain sufficient detail.

  • These concerns did not provide assurance that the service’s internal audit systems were having a positive impact on quality governance.
  • Governance arrangements did not always operate effectively (for example regarding systems for logging safety alerts and learning from significant incidents).

However:

  • There were clearly defined and embedded systems and processes to keep patients safe and safeguarded from abuse.
  • Access to appointments and services took account of people’s language needs.
  • Patients fed back they were treated with kindness, respect and compassion.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure patient records include all the necessary details including details of prescribed medication to deliver safe care and treatment (Regulation 17).
  • Ensure the provider liaises with the patients NHS GP where applicable to obtain all necessary healthcare information to be able to deliver safe treatment (Regulation 12).
  • Take the necessary steps to ensure the safe management of individual prescriptions (Regulation 12).
  • Ensure individual incidents are fully investigated to look at the root cause to minimise the risk of recurrence and ensure learning (Regulation 12).
  • Review and strengthen internal systems of assurance such as audits to deliver effective governance arrangements for the surgery (Regulation 17).

The areas where the provider should make improvements are:

  • Ensure team meetings are properly recorded for staff who cannot attend in person.

24 August 2018

During a routine inspection

We carried out an announced comprehensive inspection on 24/08/18 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The CQC inspected the service on 29/08/17 and asked the provider to make improvements regarding safeguarding service users from abuse and improper treatment, staffing and good governance. We checked these areas as part of this comprehensive inspection and found the issues identified at the last inspection had been addressed.

The owner of the service is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

  • The shortfalls identified at our previous inspection of the service had been mitigated by the provider.
  • There was a system for reporting, investigating and learning from incidents, complaints and safeguarding issues.
  • There were effective arrangements to respond to emergencies and major incidents.
  • Staff were aware of current evidence based guidance and they were appropriately trained to carry out their roles.
  • People’s privacy and dignity was respected.
  • The provider was focused on meeting the needs of the local population.
  • Systems were in place to gather feedback from patients and staff.
  • There were appropriate arrangements for managing risk.

There were areas where the provider could make improvements and should:

  • Review procedures for sharing information with patients’ NHS GPs.
  • Continue to develop quality assurance systems and clinical leadership.
  • Review the vision and strategy for the service.

29 August 2017

During a routine inspection

We carried out an announced inspection on 29 August 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check on concerns we had received and whether the registered provider was meeting the legal requirements within the Health and Social Care Act 2008 and associated regulations.

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations. We have told the provider to take action (see full details of this action in the requirement notice section at the end of this report).

Are services effective?

We found that this service was providing not effective care in accordance with the relevant regulations (see full details of this action in the requirement notice section at the end of this report).

.Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations. We have told the provider to take action (see full details of this action in the requirement notice section at the end of this report).

Background

Poland Medical is an independent provider of medical services and treats both adults and children in the London Borough of Ealing. Services are provided primarily to Polish people. Services are available to people on a pre-bookable appointment basis. The clinic employs doctors on a sessional basis most of whom are specialists providing a range of services from gynaecology to psychiatry. Medical consultations and diagnostic tests are provided by the clinic however no surgical procedures are carried out.

The clinic also provides dental services. A copy of the full report of the dental service is available on our website:

http://www.cqc.org.uk/search/services/doctors-dentists

The property is leased by the provider and consists of a patient waiting room & reception area, one dental surgery and three medical consultation rooms which are all located on the ground floor of the property.

Poland Medical is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, surgical procedures and treatment of disease, disorder or injury.

The clinic is owned by an organisation and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Poland Medical is the owner of the service.

The clinic employs 13 doctors all of whom are registered with the General Medical Council (GMC) with a licence to practice. The doctors work across both the West London and Coventry locations. Other staff include the registered manager and a team of reception staff. Poland medical is a designated body (an organisation that provides regular appraisals and support for revalidation of doctors) with one of the specialist doctors as a responsible officer (individuals within designated bodies who have overall responsibility for helping with revalidation). The doctor is also medical advisor to the clinic.

The clinic is open Monday to Friday from 8am to 8pm, Saturday from 8am to 5pm and Sunday from 11am to 6pm. The provider does not offer an out of hours service or emergency care. Patients who require emergency medical assistance or out of hours services are requested to contact NHS direct or attend the local accident and emergency department.

Our key findings were:

  • Systems and processes were in place to keep patients safe. However, we identified some shortfalls in relation to safeguarding children, staff recruitment, infection control and the management of prescription pads.
  • There was some evidence that staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Some quality improvement was evident however it was limited particularly in relation to clinical audit. There were no medicine audits carried out to monitor the effectiveness of prescribing.
  • Information about the services and how to complain was available. Complaints were dealt with in a timely way.
  • Governance arrangements were in place however there was no program of continuous clinical and internal audit and no structured meetings that allowed for the sharing of learning from complaints and significant events with all staff.
  • There were no multi-disciplinary meetings.
  • We did not see any evidence of clinical supervision.
  • There was no system for the reconciliation of pathology test results.

We identified regulations that were not being met and the provider must:

  • Ensure patients are protected from abuse and improper treatment.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Introduce formal supervision and support for clinical staff.

In addition the provider should:

  • Review how prescription pads are managed.
  • Develop the vision for the clinic and implement a strategy to deliver it.
  • Update policies and procedures to include review dates.
  • Review the system of managing communication with a patient’s NHS doctor.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

29 August 2017

During a routine inspection

We carried out an announced inspection on 29 August 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check on concerns raised which we had received and whether the registered provider was meeting the legal requirements within the Health and Social Care Act 2008 and associated regulations. The inspection was led by two CQC inspectors who were supported by two specialist advisers.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Poland Medical is an independent provider of medical services and treats both adults and children in the London Borough of Ealing. Services are provided primarily to Polish patients. Services are available to people on a pre-bookable appointment basis. The clinic provides dental services and a variety of other additional services including gynaecology services.

The property is leased by the provider and consists of a patient waiting room & reception area, one dental surgery and three medical consultation rooms which are all located on the ground floor of the property.

Practice staffing providing dental services consists of two dentists, one dental nurse, one trainee dental nurse and two receptionists.

The practice is owned by an organisation and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Poland Medical was the owner of the service

During the inspection we spoke with the registered manager and two receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between Monday to Friday 8am to 8pm, Saturdays 8am to 5pm and Sundays 11am to 6pm

Our key findings were:

  • The practice was clean and well maintained.
  • The practice had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The practice had systems to help them manage risk.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had thorough staff recruitment procedures.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system met patients’ needs.
  • The practice had effective leadership. Staff felt involved and supported and worked well as a team.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice dealt with complaints positively and efficiently.
  • Governance systems required improvement to ensure audits were undertaken regularly and were used to drive improvements.
  • The clinical staff provided patients’ care and treatment in line with current guidelines however improvements could be made consistency in the completion of dental care records and giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

There were areas where the provider could make improvements and should:

  • Review the practice’s audit protocols to ensure audits of various aspects of the service, such as radiography and infection prevention and control are undertaken at regular intervals to help improve the quality of service. Practice should also ensure, that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.
  • Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
  • Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the radiograph, the reporting and quality of the radiograph giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
  • Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

14 November 2012

During a routine inspection

During our visit we were not able to speak to people who use the service. However, we looked at information gained by the provider through a recent feedback survey they had carried out. The feedback told us that people felt informed about their treatment and that they were treated with respect. People indicated that they chose to use the service due to the Polish speaking doctors and their confidence in the skills of the doctors they met with.

However, during the inspection we found that the service was providing dental services to people. The service is not currently registered with the CQC to provide this service, as it is not registered for the regulated activity of Surgical Procedures. We have asked the provider to submit a complete application to the CQC. We have informed the provider that it is an offence to provide a dental service untl the serviced is registered for the regulated activity of Surgical Procedures.

24 May 2011

During an inspection in response to concerns

We received information from the Accountable Officer of the Local Primary Care Trust which raised concerns about how medicines were prescribed and managed in the clinic. We visited the clinic twice to speak to staff and review records.

Patients were not asked about this outcome on this occasion due to the nature of the information provided.