The Care Quality Commission
  • Doctor
  • GP practice

Kington Medical Practice

Overall: Good read more about inspection ratings

The Surgery, Eardisley Road, Kington, Herefordshire, HR5 3EA (01544) 230302

Provided and run by:
Kington Medical Practice Partnership

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Kington Medical Practice 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 Kington Medical Practice, you can give feedback on this service.

7 November 2022

During an inspection looking at part of the service

We carried out an announced focused inspection at Kington Medical Practice on 4 November 2022 Overall, the practice is rated as good.

Safe - not inspected

Effective - not inspected

Caring - not inspected

Responsive - not inspected

Well-led - good

Following our previous inspection on 4 February 2022, the practice was rated good overall and for all key questions but requires improvement for providing well led services.

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

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from a previous inspection. Therefore as part of this focused inspection we inspected the well led question to follow up on the previous breach requiring the practice to establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. In addition we also reviewed the practices efforts to engage with patients and encourage attendance at cervical screening appointments as well as their current work in the recording and reflecting on positive outcomes following quality improvement initiatives and clinical audits. This inspection included a comprehensive review of information and a remote interviews with staff working at the practice.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included

  • Conducting staff interviews using video conferencing.
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.

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 found that:

  • At this inspection, we found that systems for monitoring and acting on safety alerts had been strengthened. Additional support systems were in place to ensure staff were competent to carry out their roles.
  • The practice had a clear vision and credible strategy to provide high quality sustainable care. They used a business plan to identify challenges and aimed to improve quality of care.
  • Data published by UK Health Security Agency for 22 June 2022 for the percentage of persons eligible for cervical cancer screening were screened adequately within a specified period (within 3.5 years for persons aged 25 to 49, and within 5.5 years for persons aged 50 to 64) remained under national targets. The practice continued to encourage patients to attend screening appointments and offered additional appointments on weekends and outside of work house. Female sample takers were available and systems were in place to call and recall patients who had not attended their cervical screening appointments. Unverified data sent by the practice 5 November 2022 showed 73% persons aged 25 to 49 and 82% of persons aged 50 to 64 had attended their appointments.
  • Formal employee immunisation process and guidance systems were not in place at the time of the inspection. In particular, there was no standard working procedures in place related to the immunisation of staff. In addition there were members of staff working without up to date immunisations or risk assessments to mitigate risk to themselves and patients whilst working unvaccinated.

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

  • Continue with efforts to engage with patients and encourage attendance at cervical screening appointments.
  • Take action to improve the employee immunisation programme or you could say Take steps to evidence that an effective employee immunisation programme is in place.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

30 November 2021

During a routine inspection

We carried out an announced inspection at Kington Medical Practice on 30 November 2021. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led – Requires Improvement

Why we carried out this inspection

An inspection was due at this service as it had not been inspected under its current CQC registration. Therefore, this inspection involved a comprehensive review of information with a short site visit.

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 and reviewing 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

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • The practice had been influential in the delivery of primary care services since the start of the Covid-19 pandemic. This included setting up the first Covid-19 vaccination site in the Leominster area and stepping forward to become an ‘Amber hub’ for patients in their Primary Care Network (PCN).
  • The practice organised and delivered services to meet patients’ needs. Evidence demonstrated that people were able to access care and treatment in a timely way.
  • There were clear responsibilities, roles and systems of accountability and management; however, this required strengthening in some areas to support good governance. This was evident in the practices employee immunisation programme and the practices system for receiving safety alerts.
  • The practice had a wide range of skilled staff who were competent to carry out their roles and although nurse prescribers confirmed that they were supervised, there was no formal supervision in place to demonstrate this.
  • The practice involved the public, staff and external partners to sustain high quality and sustainable care. Staff dealt with patients with kindness and respect and involved them in decisions about their care. The practice managed incidents, complaints and issues with candour, openness and honesty.
  • The practice actively participated in social prescribing, well-being and befriending schemes facilitated through their Primary Care Network (PCN).

We found a breach of regulations. The provider must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Additionally, the provider should:

  • Continue with efforts to engage with patients and encourage attendance at cervical screening appointments.
  • Continue with current work in the recording and reflecting on positive outcomes following quality improvement initiatives and clinical audits.

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