We carried out an announced comprehensive inspection at Sudbury and Alperton Medical Centre on 16 January 2019 as part of our inspection programme.

At the last inspection in November 2014 we rated the practice as good overall. Previous reports on this practice can be found on our website at: https://www.cqc.org.uk/location/1-538804637.

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 requires improvement overall.

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

• Risks to patients were assessed and well managed in some areas, with the exception of those relating to safety alerts, some safeguarding procedures and the management of legionella.
• The practice did not have appropriate systems in place for the safe management of medicines, including the monitoring of some high risk medicines.
• The practice had not appropriately managed some fire safety procedures.
• Electrical installation condition inspection was not carried out at both premises.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. When incidents did happen, the practice learned from them and improved their processes. However, we noted significant events were not documented during staff team meetings.
• Recruitment checks were carried out in accordance with regulations.

We rated the practice as requires improvement for providing well-led services because:

• There was a lack of good governance in some areas.
• There was no formal monitoring system for following up patients experiencing poor mental health and patients with dementia who failed to collect their prescriptions in a timely manner; or to identify and monitor who was collecting the repeat prescriptions of controlled drugs from the reception.
• There was an ineffective system in place to monitor the use of blank prescription forms for use in printers and handwritten pads. The practice had recently developed a policy and was in the process of implementing changes.
• The practice was aware of and complied with the requirements of the Duty of Candour.
• Staff we spoke with on the day of inspection informed us there was a clear leadership structure and they felt supported by the management.

We rated the practice as good for providing effective, caring and responsive services because:

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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 practice was encouraging patients to register for online services and 46% of patients were registered to use online Patient Access.
• Information about services and how to complain was available and easy to understand.

We have rated this practice as good for all population groups, except requires improvement for Families, children and young people for providing effective services, because of low uptake rates for the national childhood vaccination programme.

The areas where the provider must make improvements are:

• Ensure that care and treatment is provided in a safe way.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Review formal sepsis awareness training needs for non-clinical staff to enable them to identify patients with severe infections.
• Continue to improve, monitor and encourage uptake of childhood immunisation and cervical screening.
• Continue to monitor and act on patient satisfaction with telephone access to the practice.

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

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

Sudbury and Alperton Medical Centre provides a GP service to approximately 8027 patients in Brent. Sudbury and Alperton Medical Centre is based at two locations (branches), Ealing Road, Brent and Watford Road, Harrow. We visited the Brent location as part of this inspection.

We carried out an announced comprehensive inspection of Sudbury and Alperton Medical Centre on 29 October 2014 and 19 November 2014 (PM). Overall the practice is rated as good. Specifically, we found the practice to be good at providing well-led, safe, effective, caring and responsive services.

Our key findings were as follows:

• Patients were overall satisfied with the service. They said the staff were able to get an appointment within a reasonable time, staff involved them in decision making about their care and were kind and respectful.
• Medicines were managed safely and infection control measures were in place.
• Staff were suitably qualified and received sufficient training to meet patients needs.
• The practice sought feedback form patients and staff and acted on it to improve the services provided.

However, there was one area where the provider needed to make am improvement. 

        An automated external defibrillator should be available for medical emergencies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice