Background to this inspection
Updated
25 March 2020
The Maltings Surgery provides a range of primary medical services from its premises at 8 – 10 Victoria Street, St Albans, Hertfordshire, AL1 3JB.
The practice is part of STAHFED, the St Albans and Harpenden GP federation. The practice is also in the early stages of participating in a Primary Care Network (PCN). (A Primary Care Network is a group of practices working together to provide more coordinated and integrated healthcare to patients).
The provider is registered with CQC to deliver five Regulated Activities. These are: diagnostic and screening procedures; maternity and midwifery services; family planning services; surgical procedures; and treatment of disease, disorder or injury. Services are provided on a General Medical Services (GMS) contract (a nationally agreed contract) to approximately 18,879 patients. The practice has a registered manager in place. (A registered manager is an individual registered with CQC to manage the regulated activities provided).
The practice is within the Hertfordshire local authority and is one of 58 practices serving the NHS Herts Valleys Clinical Commissioning Group (CCG).
The practice team consists of two female and three male GP partners. There are six female salaried GPs (one of whom is currently absent) and two female retainer GPs. There are two paramedics, six practice nurses (two of whom are prescribers), a healthcare assistant, three phlebotomists (all in cross-roles as administration staff), a practice manager, a deputy practice manager, 10 administration, summariser and secretarial staff, and 12 patient care advisers (a receptionist type role).
The practice serves a below average population of those aged 65 years and over. The practice population is predominantly white British and has a Black and minority ethnic (BME) population of approximately 15% (2011 census), most of whom are from south Asian communities. Information published by Public Health England rates the level of deprivation within the practice population as 10. This is measured on a scale of one to 10, where level one represents the highest levels of deprivation and level 10 the lowest.
An out of hours service for when the practice is closed is provided by Herts Urgent Care and can be accessed via the NHS 111 service.
Updated
25 March 2020
We carried out an inspection of this service due to the length of time since the last inspection. Following our review of the information available to us, including information provided by the practice, this inspection looked at the following key questions: safe, effective, caring, responsive and well-led.
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 rated the practice as good overall. We rated the practice as requires improvement for the families, children and young people population group and good for all other population groups.
We rated the practice as good for providing safe, effective, caring, responsive and well-led services because:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs. The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Staff had the skills, knowledge and experience to deliver effective care and treatment.
- Staff involved patients in their care and treatment decisions and treated them with kindness, dignity and respect.
- 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-centred care and an inclusive, supportive environment for staff. There was a focus on continuous learning and improvement at all levels of the practice.
Whilst we found no breaches of regulations, the provider should:
- Implement comprehensive staff related processes to include all staff completing essential training at the appropriate level for their roles, a review of the policy and process around staff Disclosure and Barring Service (DBS) checks including considering if all staff who chaperone should receive one, and nursing and paramedic staff receiving a formal, structured audit of their work (including prescribing and minor illness roles) against set criteria to assess their competency and autonomous decision-making.
- Take steps so that existing infection prevention and control processes are strengthened. This includes those relating to defining, updating, or removing infection control audit actions and ensuring water temperatures at the practice are within the required levels.
- Strengthen policies, systems and processes in relation to the appropriate management of Patient Group Directions (PGDs), the coding of completed patient medicine reviews on the clinical system, the timely and appropriate receipt of safety alerts including Medicines and Healthcare products Regulatory Agency (MHRA) alerts.
- Increase the uptake of child immunisations and women attending for their cervical screening.
- Continue to identify and support carers in the practice population.
- Make the full complaints process and procedure readily available and accessible on the practice’s website.
- Continue to take steps to improve levels of patient satisfaction in relation to the National GP Patient Survey results and access to the practice.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care