The Care Quality Commission
  • Doctor
  • GP practice

The Chestnuts Surgery

Overall: Good read more about inspection ratings

70 East Street, Sittingbourne, Kent, ME10 4RU (01795) 423197

Provided and run by:
The Chestnuts Surgery

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about The Chestnuts Surgery on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about The Chestnuts Surgery, you can give feedback on this service.

13 November 2019

During an annual regulatory review

We reviewed the information available to us about The Chestnuts Surgery on 13 November 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

14 February 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Chestnuts Surgery on 26 July 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for The Chestnuts Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 14 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 26 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

  • The practice had revised the system that managed and recorded actions taken as the result of receiving national patient safety alerts.

  • The practice was able to demonstrate that risks to patients, staff and visitors were being assessed and well managed.

  • The practice had revised clinical audit activity to help ensure it was driving quality improvement.

  • The practice had made improvements to help ensure staff maintained accurate, complete and contemporaneous records in respect of each service user.

  • The practice had introduced systems to help ensure results were received for all samples sent for the cervical screening programme as well as to help ensure women who were referred as a result of abnormal results were followed up.

  • The practice had introduced a system that identified patients who were also carers. The practice had identified 28 patients on the practice list who were also carers.

  • Governance arrangements had been revised to help ensure they were effectively implemented.

  • The practice had introduced a system to help keep all governance documents up to date.

However, there were also areas of practice where the provider needs to make improvements.

In addition the provider should:

  • Continue to identify patients who are also carers to help ensure eligible patients are offered relevant support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

26 July 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Chestnuts Surgery on 26 July 2016. Overall the practice is rated as requires improvement.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system for reporting and recording significant events.
  • The practice was unable to demonstrate the action taken as a result of receiving national patient safety agency alerts.
  • Risks to patients were not always assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • There was limited evidence of clinical audits driving quality improvement.
  • Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Accurate, complete and contemporaneous records in relation to each service user were not always maintained.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Most patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice provided primary care services for a local hostel where prisoners released from local prisons and people who were temporarily homeless were housed. They worked with local substance misuse services to provide shared care to these vulnerable people.
  • Governance arrangements were not always effectively implemented.
  • There was a clear leadership structure and staff felt supported by management. The practice gathered feedback from patients through the patient participation group (PPG), complaints received and by carrying out analysis of the results from the Friends and Family Test.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvements are;

  • Revise the system and ensure national patient safety agency alerts are responded to in a timely and appropriate manner.
  • Revise the system to monitor and record the hepatitis B status of all clinical staff.
  • Revise risk assessment and management to include all associated risks from fire and legionella.
  • Revise clinical audit activity to ensure improvements to patient care are driven by the completion of clinical audit cycles.
  • Revise record keeping to ensure accurate, complete and contemporaneous records are maintained in respect of each service user.

  • Revise governance processes to help ensure that all policy and procedure documents used to govern activity are up to date.

The areas where the provider should make improvements are;

  • Revise systems to help ensure results are received for all samples sent for the cervical screening programme and the practice follows up women who are referred as a result of abnormal results.

  • Improve the system that identifies patients who are also carers to help ensure eligible patients are offered relevant support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

26 March 2014

During an inspection looking at part of the service

Training and guidance was in place along with checks to establish suitability to work with vulnerable people and children to help protect people using the service.

Medicines were managed safely. Processes were in place to audit medicines for use in an emergency, and prescription pads were kept securely with systems in place to identify missing prescriptions.

9 September 2013

During a routine inspection

We found that people's individual needs were assessed at each visit and care and treatment was planned and delivered to maintain people's welfare and safety. There were arrangements in place for dealing with foreseeable emergencies.

People were not fully protected from abuse because of a lack of training for staff and a lack of awareness of their roles and responsibilities in relation to abuse.

People were protected against the risks associated with infection because appropriate procedures were followed by the staff.

Medicines were not always kept safely, and the processes to ensure the security of medicines and prescription pads had not been risk assessed.

There were robust and effective systems for assessing and monitoring the quality of the service. People's views were sought and acted upon .