The Care Quality Commission
  • Doctor
  • GP practice

Parkbury House Surgery

Overall: Good read more about inspection ratings

St Peters Street, St Albans, Hertfordshire, AL1 3HD (01727) 851589

Provided and run by:
Parkbury House Surgery

All Inspections

23 November 2021

During an inspection looking at part of the service

We carried out an announced inspection at Parkbury House Surgery on 23 November 2021. Overall, the practice is rated as Good.

Set out the ratings for each key question

Safe - Good

Effective - Good

Well-led - Good

Following our previous inspection on 26 February 2020, the practice was rated Requires Improvement overall. The practice was rated as inadequate for providing safe services, requires improvement for providing effective and well-led services and good for providing caring and responsive services.

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

Why we carried out this inspection

This inspection was a focused inspection to follow up on:

  • The key questions inspected: are services safe, effective and well-led.
  • Any breaches of regulations and areas we identified where the provider should make improvements identified in the previous inspection.

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
  • Speaking with a member of the Patient Participation Group (PPG) on the telephone
  • 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 and
  • information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall

We rated the practice as good for providing safe services because:

  • Improvements had been made to the management of test results and systems for monitoring of patients who were prescribed high-risk medicines.
  • An improved protocol for the management of safety alerts had been effective in minimising risks.
  • There was a focus on recalling patients who had not received a blood pressure reading due to the national pandemic and previous national lockdown measures.
  • Staff were in the process of transferring staffs employment records onto a digital platform. Whilst progress had been made; staff were aware of further work to improve the ease of access to staff records

We rated the practice as good for providing effective services because:

  • Enhancements had been made to quality and improvement systems ensuring effective oversight and actions taken to improve safety and performance.

We rated the practice as good for providing well-led services because:

  • Governance structures had been strengthened and there were clear responsibilities, roles and systems of accountability to support good governance and management.

Whilst we found no breaches of regulations, the provider should:

  • Continue to work on the management and digital storage of staff files, to support ease of access when needed.
  • Continue to encourage patients to submit blood pressure readings or attend for appointments for blood pressure reviews as needed.
  • Continue with efforts to recruit clinical and non-clinical staff.
  • Continue taking action to improve the uptake of cervical cancer screening

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

26 February 2020

During an inspection looking at part of the service

We carried out an inspection of this service following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a significant change to the quality of care provided since the last inspection.

This inspection focused on the following key questions: safe, effective and well-led.

Because of the assurance received from our review of information we carried forward the ratings for the following key questions: caring and responsive.

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 requires improvement overall, with ratings of inadequate for providing safe services and requires improvement for providing effective and well-led services. We rated the practice as requires improvement for the people with long-term conditions and w orking-age people (including those recently retired and students) population groups and good for all other population groups.

We rated the practice as inadequate for providing safe services because:

  • Staff did not always have the information they needed to deliver safe care and treatment. Not all pathology test results, including those older than one week, were clearly identified as reviewed and actioned or awaiting further action.
  • The practice’s systems for the appropriate and safe use of medicines, including medicines optimisation, were not always comprehensive. The process for monitoring patients’ health in relation to the use of high-risk medicines with the appropriate monitoring and clinical review prior to prescribing was insufficient.
  • The system for acting on safety alerts was not comprehensive.

We rated the practice as requires improvement for providing effective services because:

  • The practice’s quality monitoring and improvement systems were not always effective at identifying and resolving issues, concerns, or below averages performance.

We rated the practice as requires improvement for providing well-led services because:

  • The practice did not always have effective governance structures, systems, and processes in place. This included those in relation to staff DBS checks, staff vaccinations, staff training, fire safety systems, Legionella management, the control of water temperatures, the monitoring of blank prescription stationery, the management of pathology test results, the monitoring and review of patients prescribed high-risk medicines, and the system for acting on safety alerts.

Please see the final section of this report for specific details of our concerns.

The areas where the provider must make improvements are:

  • 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.

Please see the final section of this report for specific details of the action we require the provider to take.

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

13 January 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkbury House Surgery on 13 January 2016. Overall the practice is rated as good.

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 in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Patients were positive about the standard of care they received and about staff behaviours. They said staff were supportive and caring and that their privacy and dignity was respected.
  • Information about services and how to complain was available and easy to understand.
  • Patients were positive about access to the practice and appointments, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • 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 should make improvements are:

Ensure staff have access to up-to-date Patient Group Directions (PGDs).

Take steps to ensure that in future National GP Patient Surveys the practice’s areas of below local and national average performance are improved. 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice