Heacham Group Practice

We carried out an announced inspection at Heacham Group Practice on 8 March 2022. Overall, the practice is rated as inadequate. As a result of the concerns identified we issued a Section 29 warning notice on 24 March 2022 in relation to a breach of Regulation 12 Safe Care and Treatment.

Ratings for each key question are:

Safe - Inadequate

Effective – Inadequate

Caring – Good

Responsive – Requires Improvement

Well-led - Inadequate

Following our previous inspection on 25 October 2016, the practice was rated Good overall and for all key questions.

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

Why we carried out this inspection

This inspection was a comprehensive inspection. We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Norfolk and Waveney. To understand the experience of GP Providers and people who use GP services, we asked a range of questions in relation to urgent and emergency care. The responses we received have been used to inform and support system wide feedback.

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

We have rated this practice as Inadequate overall

We found that:

• We found the practice leadership had failed to ensure the practice was led and managed in a way that promoted the delivery of high-quality, person-centre care.
• The practice did not provide care in a way that kept all patients safe and protected them from avoidable harm.
• Not all patients received effective care and treatment that met their needs.
• The practice did not ensure that all medicines were prescribed safely to all patients.
• The practice failed to ensure they had clear oversight that staff had received appropriate training and competency assessments.
• The practice did not have an adequate system to learn and make improvements when things went wrong.
• The process and system to manage complaints was inadequate.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way however, published data reflected that patient satisfaction had deteriorated over time.

We found breaches of Regulations Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

For further information see the requirement notice and enforcement section at the end of this report.

In addition to the breaches of regulations, the provider should:

• Continue to identify patients who are carers and ensure appropriate support is offered to them.
• To review the system and process to ensure all patients with a learning disability receive an annual review.
• Encourage patients to uptake their appointments of the national cervical cancer screening programme
• Review and monitor the GP patient survey data to make and monitor improvements to patients’ satisfaction.
• Improve the system and process to engage with patients to form a patient participation group.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement, we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

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