The Thorndike Surgery

Updated 22 September 2022

The Thorndike Surgery is located at Longley Road, Rochester, Kent, ME1 2TH

The provider is registered with CQC to deliver the Regulated Activities: diagnostic and screening procedures; maternity and midwifery services; treatment of disease, disorder or injury; family planning; and surgical procedures.

The practice is situated within the NHS Kent and Medway Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of about 12,826. This is part of a contract held with NHS England.

There are arrangements with other providers to deliver services to patients outside of the practice’s working hours.

The practice is part of a wider network of GP practices, Rochester Primary Care Network (PCN).

Information published by Public Health England shows that deprivation within the practice population group is in the fifth decile (five of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 87.4% White, 6.7% Asian, 2.7% Mixed, 2.3% Black, and 0.9% Other.

The age distribution of the practice population closely mirrors the local and national averages.

The practice staff consists of two GP partners and six salaried GPs. The practice has a team of two nurses who provide nurse led clinics for long-term conditions, one assistant practitioner and one healthcare assistant. The GPs are supported at the practice by a practice manager, assistant practice manager and a team of reception and administration staff.

Updated 22 September 2022

We carried out an announced inspection at The Thorndike Surgery on 21 July 2022. Overall, the practice is rated as Requires Improvement.

The key questions at this inspection are rated as:

Safe - Requires Improvement

Effective – Requires Improvement

Caring - Requires Improvement

Responsive – Requires Improvement

Well-led – Requires Improvement

We carried out a focused inspection looking at the responsive domain only, on 1 February 2022, in response to concerns raised about access. The practice was rated as Requires Improvement for providing responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Thorndike Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a comprehensive inspection to provide the practice with an up to date rating.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

Our findings

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.
• information from the provider, patients, the public and other organisations.

We have rated this practice as Requires Improvement.

We have rated the practice as Requires Improvement for providing safe services because:

• The practice’s systems and processes did not always keep people safe and safeguarded from abuse.
• The practice’s systems for the appropriate and safe use of medicines, including medicines optimisation, required improvement.
• Improvements were needed to the practice’s system for recording and acting on safety alerts.

We have rated the practice as Requires Improvement for providing effective services because:

• Patients’ needs were assessed, but care and treatment was not always delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools.
• Improvements in performance related to childhood immunisations and cervical screening were required.

We have rated the practice as Requires Improvement for providing caring services because:

• The latest National GP Patient Survey results had deteriorated and showed that the practice was performing significantly lower than the local and national averages for indicators regarding patient experience.

We have rated the practice as Requires Improvement for providing responsive services because:

• The latest National GP Patient Survey results had deteriorated, and showed that the practice was performing significantly lower than local and national averages for several indicators regarding access to the practice.

We have rated the practice as Requires Improvement for providing well-led services because:

• Processes for managing risks, issues and performance required improvement.

We found that:

• Appropriate standards of cleanliness and hygiene were met.
• Staff had the information they needed to deliver safe care and treatment.
• The practice was able to demonstrate that staff had the skills, knowledge and experience to carry out their roles.
• Staff worked together and with other organisations to deliver effective care and treatment.
• Staff helped patients to be involved in decisions about care and treatment.
• Complaints were listened to as well as responded to and used to improve the quality of care.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.

We found two breaches of regulations. The provider must:

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

The areas where the provider should make improvements are:

• Review practice systems so that they always alert staff to family and other household members of children on the risk register.
• Ensure that all staff take effective action to keep data secure.
• Ensure that the practice’s cold chain policy is adhered to by practice staff.
• Continue to ensure that actions identified in risk assessments are completed in a timely manner.
• Ensure Patient Group Directions are completed fully.
• Ensure that serial numbers of blank prescription forms and pads are recorded.

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