Archived: Fir Tree Medical Centre

Updated 15 March 2019

Fir Tree Medical Centre is situated in a deprived area of Liverpool. There were 4,301 patients on the practice register at the time of our inspection.

Fir Tree Medical Centre is registered with the Care Quality Commission to carry out the following regulated activities: Diagnostic and screening procedures, Family planning, Maternity and midwifery services, Surgical procedures and Treatment of disease, disorder or injury.

The practice is part of NHS Liverpool Clinical Commissioning Group (CCG) and has a General Medical Services (GMS) contract.

The practice is managed by two GP partners and has two salaried GPs. There is one practice nurse. Members of clinical staff are supported by a practice manager, reception and administration staff.

The practice is open 8am to 6.30pm every weekday. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service, by calling NHS 111.

Updated 15 March 2019

We carried out an announced comprehensive inspection at Fir Tree Medical Centre on 15 February 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 good overall but requires improvement for providing safe services and good for all population groups.

We rated the practice as requires improvement for providing safe services because:

• Medicines management required improvement. For example, the practice had some medicines for use in medical emergencies but not all that are currently recommended. There was no risk assessment to outline how the practice would manage certain medical emergencies such as diabetic patients with very low sugar levels or patients with epilepsy, without the medicines currently recommended. Improvements were also required around the management of uncollected prescriptions, and storage of blank prescriptions.

• The practice did not have a defibrillator but could access one in a nearby building. There was no risk assessment in place to demonstrate how the practice would manage in a medical emergency.

• Recruitment procedures did not include risk assessments for the rationale why some staff did not have a Disclosure and Barring Services (DBS) check.

• There was no formal Legionella risk assessment and the fixed electrical wiring safety certificate was 16 months out of date.

We rated the practice as good for providing effective, caring, responsive and a well led service because:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

However, the provider must:

• Ensure care and treatment is provided in a safe way to patients.

The provider should:

• Carry out a risk assessment for how the practice would manage a medical emergency without a defibrillator on the premises.
• Implement a practice policy to manage uncollected prescriptions particularly for vulnerable patients.
• Carry out a risk assessment for staff who are employed without a DBS check.
• Review the storage arrangements of blank prescriptions.
• Implement a system to record safety and medicine alerts received, the action taken and record ongoing monitoring.

Since the inspection, the provider advised us that the necessary improvements outlined in our report had been or was in progress of being actioned.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Updated 15 March 2019

Updated 15 March 2019

Updated 15 March 2019

Updated 15 March 2019

Updated 15 March 2019

Updated 15 March 2019