Midlands Community Services Ltd

Updated 21 May 2019

Midlands Community Services Limited (MCS) is an organisation registered with the Care Quality Commission (CQC) based at Brewood Surgery, Kiddemore Green Road, Brewood, Stafford, ST19 9BQ. This service is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008 for treatment of disease, disorder or injury; surgical procedures; diagnostic and screening procedures and is registered as an Independent Healthcare Company. As a provider of Independent Healthcare the practice is able to offer its surgical services to patients from a much wider area than the NHS practice list at the same site. MCS is managed from Brewood Medical Practice and the directors of the company are also the GP partners at the practice.

MCS provides a vasectomy and carpel tunnel decompression service through the NHS for patients living in Staffordshire and Stoke on Trent. MCS is managed from Brewood Medical Practice and the directors of the company are also the GP partners at the practice.

Procedures are carried out at number of sites around the county, including a number of health centres in Stoke on Trent, Tamworth and Stafford plus local hospitals in Stafford, Tamworth and Lichfield. We only visited Brewood Medical Practice as part of this inspection.

The vasectomy service is commissioned by three of the Clinical Commissioning Groups in Staffordshire and the carpel tunnel decompression service is commissioned through Staffordshire and Stoke on Trent Partnership NHS Trust.

The staff team consists of two community surgeons (GPs), a lead nurse, two health care assistants, two administrators and a business manager. Both of the community surgeons are members of the Association of Surgeons in Primary Care. Clinics are usually held to meet patient need wherever possible. Some clinics operate on a weekly basis whilst others operate monthly to ensure that patients receive their surgery as close to home as possible.

We inspected Midlands Community Services Limited on 25 April 2019 as part of our inspection programme. Our inspection team was led by a Care Quality Commission (CQC) Lead Inspector. The team included a GP specialist adviser.

Before visiting we reviewed a range of information we hold about the service and asked the service to send us a range of information. This included information about the complaints received in the last 12 months and the details of their staff members, their qualifications and training. MCS provided information on the day of the inspection that included audits and policies. We sent patient comment cards two weeks prior to the inspection to gain feedback from service users. We spoke with staff from the service that included the community surgeons, business manager and administration staff.

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 therefore formed the framework for the areas we looked at during the inspection.

The service is currently redeveloping its website: http://www.midlandscommunityservices.co.uk/

Updated 21 May 2019

This service is rated as Good overall. (Previous inspection March 2018 – which was an unrated inspection in line with our inspection programme).

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

We carried out an announced comprehensive inspection at Midlands Community Services Ltd. This was to rate the service as part of our inspection programme.

Midlands Community Services Limited (MCS) is based in Brewood, Staffordshire and provides a vasectomy and carpel tunnel decompression service through the NHS for patients living in Staffordshire and Stoke on Trent.

This service is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008 for treatment of disease, disorder or injury; surgical procedures; diagnostic and screening procedures and is registered as an Independent Healthcare Company. As a provider of Independent Healthcare the practice is able to offer its surgical services to patients from a much wider area than the NHS practice list at the same site. MCS is managed from Brewood Medical Practice and the directors of the company are also the GP partners at the practice.

Dr Alexander Houlder 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.

In preparation for the inspection, the practice had been sent blank comment cards and a small collection box from CQC. The team had taken these cards and boxes with them to their surgical sites in preparation for our inspection on the 2 April 2019. We received a total of 23 completed comment cards which included patients who had undergone either vasectomy and carpel tunnel care and treatment. All 23 of the cards were very positive about the service and care received.

Feedback obtained clearly demonstrated positive outcomes for patients. Patients spoke highly of the care and treatment they had received from the clinic. They described staff as friendly, efficient, helpful and caring. They also commented that staff put them at their ease during the procedure. Staff we spoke with told us they were well supported in their work and were proud to be part of a team which provided a high-quality service.

Our key findings were:

• Patients received detailed and clear information about their proposed treatment which enabled them to make an informed decision.
• Patients were offered convenient, timely and flexible appointments at a location of their choice.
• Staff helped patients to be involved in decisions about their care. Patients were provided with patient information packs containing written pre and post treatment literature.
• There was a transparent approach to safety with demonstrably effective systems in place for reporting and recording adverse incidents.
• There were effective procedures in place for monitoring and managing risks to patient and staff safety. For example, there were arrangements to prevent the spread of infection.
• The service had a structured programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.
• There was effective leadership, management and governance arrangements in place that assured the delivery of high-quality care and treatment.

The areas where the provider should make improvements are:

• Seek assurances that appropriate risk assessments are in place at the sites managed by other providers.
• Obtain information about any relevant physical or mental health conditions for all newly appointed members of staff.
• Maintain a log of significant events and complaints from all data sources to monitor events over time for any trends.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care