We carried out a review of the data available to us about Burnham Health Centre 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 Burnham Health Centre, you can give feedback on this service.
Our previous comprehensive inspection in November 2015 found breaches of regulations relating to the safe, effective and responsive delivery of services.
We found Burnham Health Centre required improvement for the provision of safe, effective and responsive services. The practice was rated good for providing caring and well-led services. Consequently we rated all population groups as requiring improvement.
This inspection in July 2016 was undertaken to check the practice was meeting regulations that were in breach from the last inspection. For this reason we have only rated the location for the key questions to which these relate. This report should be read in conjunction with the full inspection report of 5 November 2015.
We found the practice had made improvements since our last inspection. At our inspection on the 21 July 2016 we found the practice was meeting the regulations that had previously been breached.
Specifically we found:
We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services. Consequently we have rated all population groups as good.
Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Burnham Health Centre, Minniecroft Road, Burnham, SL1 7DE on 5 November 2015. Overall the practice is rated as requires improvement.
Specifically, we found the practice to require improvement for provision of safe, effective and responsive services. It was good for providing caring and well-led services. The concerns which led to these ratings apply to all population groups using the practice.
Our key findings across all the areas we inspected were as follows:
Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. The majority of information about safety was recorded, monitored and reviewed.
Risks to patients and staff were assessed and well managed in some areas, with the exception of those relating to recruitment checks and safeguarding adult training.
We found that completed clinical audits cycles were driving positive outcomes for patients.
Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Most staff had the skills, knowledge and experience to deliver effective care and treatment. However, some staff had not received annual appraisals and completed mandatory training.
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 were available and easy to understand.
Patients said they found it difficult to make an appointment with a named GP and had to wait a long time to get through to the surgery by telephone each morning. Urgent and online appointments were available the same day.
The practice had excellent facilities and was well equipped to treat patients and meet their needs.
Anti-coagulation clinic (An anti-coagulant is a medicine that stops blood from clotting) was offered onsite, meaning 350 patients who required this service did not have to travel to local hospitals.
There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
The provider was aware of and complied with the requirements of the Duty of Candour.
The areas where the provider must make improvements are:
Ensure all necessary recruitment checks are in place including systems for assessing and monitoring risks.
Ensure all staff have received annual appraisals and undertaken all mandatory training.
Further review the appointments booking system and the waiting time it takes to get through to the practice by telephone. Improve the availability of non-urgent appointments with a named GP.
Ensure two new partners are added to the practice’s CQC registration.
In addition the provider should:
Ensure there are formal governance arrangements in place including systems for assessing and monitoring risks and the quality of the service provision.
Update procedures for checking medicines in GPs home visit bags.
Chief Inspector of General Practice