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Inspection Summary


Overall summary & rating

Good

Updated 24 August 2021

We carried out an announced inspection at Harraton Surgery on 28 July 2021. Overall, the practice is rated as good.

The key question ratings were as follows:

Safe - Good

Effective – Good

Well-led – Requires Improvement

Following our previous inspection on 1 October 2019, the practice was rated Good overall and for all key questions apart from whether the service was well-led, which we rated as requiring improvement. This was because we had a concern about the capacity of the lead GP providing sessions across all four sites and the sustainability of this going forward.

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

Why we carried out this inspection

This inspection was a follow-up inspection, to check what progress the provider had made to improve on those areas we said they should at the last inspection. As we had received some information of concern, we inspected the three key questions, Safe, Effective and Well Led as part of our new methodology to carry out more focused inspections for those practices rated as good overall. All other ratings were carried forward from the October 2019 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
  • 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 and good for all population groups, apart from people with long-term conditions, which we rated as requires improvement.

We rated the practice as requires improvement for being effective for people with long term conditions because:

  • Care and treatment was not always delivered in line with current best practice.

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

  • The leadership, governance and culture did not always support the delivery of high-quality sustainable care
  • There was a culture of blaming others for incidents rather than looking objectively at what the practice could change to improve the care and support they offered to patients.
  • Communication mechanisms within the practice were ineffective.
  • The practice continued to struggle to build a sustainable and stable clinical team and there was low morale amongst staff.

We also found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Staff worked together and with other organisations to deliver effective care and treatment.
  • Staff were not always given protected time to complete learning and development, because of the pressures of work.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.

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

  • Develop a culture of effective communication, which encourages candour, openness and honesty, supports effective learning and improvement and builds team morale.
  • Develop the process for significant events to build in effective identification and sharing of learning, which supports the duty of candour.
  • Continue to develop clinical governance processes to provide assurance that care and treatment are delivered in line with good practice and evidence-based guidance.
  • Develop and implement an effective strategy to build a sustainable and stable clinical team. Provide support for staff by continuing with the planned work on appraisals and the competence-based staff development framework.
  • Put in place appropriate authorisations to administer medicines via Patient Group Directions.

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

Inspection areas

Safe

Good

Effective

Good

Caring

Good

Responsive

Good

Well-led

Requires improvement
Checks on specific services

People with long term conditions

Requires improvement

Families, children and young people

Good

Older people

Good

Working age people (including those recently retired and students)

Good

People experiencing poor mental health (including people with dementia)

Good

People whose circumstances may make them vulnerable

Good