Archived: Harraton Surgery

Updated 22 January 2015

Harraton Surgery is located in Harraton Village in the Washington area of Sunderland. The surgery is based in a two storey converted house. On the ground floor there is a reception area, a treatment room and a consultation room. There is an additional consultation room on the first floor.

Dr Inder Jeet Singh is the sole registered provider for the practice. Working alongside him is a female locum GP, a practice nurse, a healthcare assistant, a practice manager and secretarial and administration staff. Most staff work part time hours.

Surgery opening times are between 8:00am and 6.00pm Monday to Friday. An extended surgery is provided on a Wednesday evening between 6:00pm to 7:00pm. In addition to the practice there are three minor injuries and illness units in the Washington and Sunderland area, where patients can access services between 8:00am to 8:00pm everyday. The practice is supported with out-of-hours provision from the 111 service between 8pm and 8am and all day at weekends and on bank holidays.

The patient list size for Harraton Surgery is 2148 (as at 30 June 2014). The majority of patients are between the ages of 18 and 65. Approximately 200 patients are over the age of 65, with only a very small number living in a local care home. The majority of patients come from the villages of Harraton, Crowther, High Rickleton and Lambton Park in the Washington area. However some patients are registered from the surrounding areas following the closure of a previously linked practice.

This was the first time the practice had been inspected by the Care Quality Commission (CQC). At the point of registration the practice declared it was fully compliant with the regulations.

Dr Singh has only one registered location as part of this registration. Dr Singh also has two other GP practices, which were registered separately. All three practices have separate patients lists. Only Harraton Surgery was visited as part of this inspection. Dr Singh was reviewing how all three practices were registered with CQC. 

Updated 22 January 2015

Harraton Surgery is located in the village of Harraton in the Washington area of Sunderland. Dr Inder Jeet Singh is the registered manager for Harraton Surgery.

At this inspection we found there was a lack of clear leadership and vision within the practice. Governance arrangements were unclear. Although staff told us about actions they had taken to improve the service, there was a lack of a documented audit trail to evidence this.

The practice could not demonstrate an understanding of what their key strengths were and what they had identified as areas for improvement. We found that practice was responsive in its approach to quality, rather than proactively planning for improvements. The provider was in breach of regulations relating to assessing and monitoring the quality of service; ensuring that premises were safe and accessible for patients, staff and visitors; and, having adequate processes in place to safeguard vulnerable children, young people and adults from abuse.

Patients told us they had no problems in accessing appointments and were usually able to get appointments quite quickly. Most patients also told us that staff treated them with dignity and were responsive to their needs.

We found care and treatment took account of recognised best practice standards and guidelines.

The majority of patients registered with the practice were of working age. There were approximately 200 patients registered with the practice over the age of 65, with a very small number of these living in a local care home. Of all patients, 51.1% were categorised as having a long term condition. Overall the practice made appropriate provision for each population group to ensure the practice  was caring. However, further improvements were required to make sure the practice was safe, effective, responsive and well-led.

Regulated activities

The practice registered with the Care Quality Commission (CQC) on 1 April 2013 to deliver care under the following regulates activities:-

• Diagnostic and screening procedures;
• Family planning;
• Maternity and midwifery services;
• Surgical procedures;
• and, Treatment of disease, disorder or injury. 

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Updated 22 January 2015

The practice made appropriate provision to ensure the service for people with long term conditions was caring. However further improvements were required to make sure the practice was safe, effective, responsive and well-led.

There were regular chronic disease clinics in place to monitor the health and wellbeing of patients with long term conditions. Care plans were in place for those who were at most risk of deteriorating health and whose conditions were less well controlled.

There were mechanisms for communicating with other community healthcare professionals to ensure important information about patients care and treatment was shared.

Updated 22 January 2015

The practice made appropriate provision to ensure the service for mothers, babies, children and young people was caring. However further improvements were required to make sure the practice was safe, effective, responsive and well-led.

Although arrangements were in place to identify and take action where babies, children and young people were at risk of abuse, staff were unclear about what these arrangements were.

Vaccinations and health checks were available to ensure the health and progress of babies, young children, expectant and new mothers. There were arrangements in place to support good sexual health awareness for young people.

Updated 22 January 2015

The practice made appropriate provision across the practice to ensure the service for older people was caring. However further improvements were required to make sure the practice was safe, effective, responsive and well-led.

Although arrangements were in place to identify and take action where older patients were at risk of abuse, some staff were unclear about what these arrangements were.

Regular meetings took place with healthcare professionals from other agencies, to ensure information was shared for those most at risk and vulnerable older patients. Care plans were in place for those at risk of quickly deteriorating health.

Updated 22 January 2015

The practice made appropriate provision to ensure the service for the working-age population and those recently retired was caring. However further improvements were required to make sure the practice was safe, effective, responsive and well-led.

Patients told us they had no problems in accessing appointments and were usually able to get appointments quite quickly. We found a range of appointment times and types were available to meet patients’ needs.

Information was available within the practice to inform patients about common conditions and their symptoms, promotion of healthy lifestyles and prevention of ill health.

Updated 22 January 2015

The practice made appropriate provision to ensure the service for people experiencing poor mental health was caring. However further improvements were required to make sure the practice was safe, effective, responsive and well-led.

The practice enabled other healthcare professionals to use consulting rooms within the practice so patients could access services close to home. The practice developed care plans for those patients with enduring mental health conditions most at risk of relapse.

Updated 22 January 2015

The practice made appropriate provision to ensure the service for people in vulnerable circumstances who may have poor access to primary care was caring. However further improvements were required to make sure the practice was safe, effective, responsive and well-led.

The practice told us that they offered the same service to all patients, irrespective of social or lifestyle choices.

We found the practice had not sufficiently considered the needs of people with disabilities who might have problems accessing the building.