The Care Quality Commission
  • Doctor
  • GP practice

Denton Village Surgery

Overall: Good read more about inspection ratings

Orchard Lane, Denton, Northampton, Northamptonshire, NN7 1HT (01604) 890313

Provided and run by:
Dr David Charles Wade

Important: The provider of this service changed - see old profile

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Denton Village Surgery 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 Denton Village Surgery, you can give feedback on this service.

05/10/2020

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Denton Village Surgery on 5 February 2019 as part of our inspection programme, and to review breaches of regulations identified at the inspection carried out on 2 April 2019. The overall rating for the practice was Good. The full comprehensive report on the February 2019 inspection can be found on our website at www.cqc.org.uk .

We are mindful of the impact of Covid-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the Covid-19 pandemic when considering what type of inspection was necessary and proportionate. This was therefore a desk-based review.

On 5 October 2020 we carried out a desk-based review to confirm that the practice had carried out their plan to meet the legal requirements in relations to the breaches of regulation we identified at our previous inspection on 5 February 2019. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

We found that improvements had been made and the provider was no longer in breach of the regulations and we have amended the rating for this practice accordingly. The practice is now rated as Good for the provision of safe services. We previously rated the practice as Good for providing effective, caring, responsive and well-led services.

During this desk-based review we looked at a range of documents submitted by the practice to demonstrate how they met the requirement notices. This included:

  • Risk assessments
  • Medicines and Healthcare products Regulatory Agency (MHRA) and patient safety alerts processes
  • Records to confirm improvements made.

During the desk-based review we looked at the following question:

Are services safe?

We found that this service was providing a safe service in accordance with the relevant regulations and had demonstrated they had acted on the required improvements and had implemented the following:

  • Arrangements had not been in place to monitor the temperature of a room where medicines were stored to ensure they were stored safely, according to the manufacturer’s guidelines. The practice had made changes which included the completion of a risk assessment and the implementation of a temperature log so that the room temperature could be monitored and managed daily by the dispensary team. An air conditioning unit had also been installed to ensure the temperature remained constant. This unit was scheduled to be serviced and maintained annually.
  • MHRA and other safety alerts had not been managed effectively to ensure that all action had been taken as required. The practice confirmed that improvements to the management of all alerts had been made. All alerts were received by email by designated key staff including the practice manager. A written protocol for handling all alerts had been implemented and had been recently updated.
  • A clear audit trail of action taken was recorded through the practice intranet. All staff had access to alerts. In addition, all alerts which were relevant for prescribers (as opposed to those solely for action by the dispensary, such as batch recalls) were circulated using a designated alert template with a link for them to read/action. The data administrator was informed of any alerts which required clinical searches and any patients identified were then reviewed by clinicians. Significant alerts were reviewed at the practice’s monthly multi-disciplinary team meetings.

During the inspection in February 2019 improvements had been identified for the population group of patients with poor mental health. The practice needed to review the care plans for patients with mental health concerns and dementia. The practice confirmed that action had been taken to improve care and treatment for patients with mental health concerns. This included:

  • Investment in templates that ensured clinicians had access to the most up to date clinical templates when conducting patient reviews.
  • Engagement with monthly Primary Care Network (PCN) led frailty reviews which allowed opportunities to link up with a social worker, the collaborative care team and other organisations such as Money Advice Service and Age UK. Most often patients selected had complex mental health needs or suffered from dementia.
  • Data showed that improvements had been made on the number of care plan reviews completed for the past year.

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


Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

5 February 2020

During a routine inspection

We carried out an announced comprehensive inspection at Denton Village Surgery on 5 February 2020 as part of our inspection programme.

At this inspection we followed up on breaches of regulations identified at a previous inspection on 2 April 2019.

At the last inspection in April 2019 we rated the practice as requires improvement for providing safe services because:

  • The practice did not have clear systems and processes to keep patients safe.
  • The practice did not have all of the required emergency drugs in stock to ensure patient safety.
  • The practice did not have an adequate system in place to safely manage MHRA and other safety alerts.
  • Staff immunisations were not being safely monitored.
  • The practice had over 500 patient notes which had not been summarised dating back to 1984. This had not been picked up by the practice prior to our inspection and posed a risk to patient safety.
  • Some of the risk assessments in place in the dispensary did not provide enough information to safely mitigate any identified risks.

At this inspection, we found that the provider had satisfactorily addressed most of these areas, although some further improvement was needed as indicated below.

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 the population groups.

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

  • The practice did not have safe systems in place to ensure all medicines were safely stored and monitored.
  • The practice did not have an adequate system in place to safely manage and action MHRA and other safety alerts.

We rated the practice as good for providing effective, caring, responsive and well-led services because:

  • Patients received effective care and treatment.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way.

(Please see the specific details on action required at the end of this report).

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

2 April 2019

During a routine inspection

We carried out an announced comprehensive inspection at Denton Village Surgery on 2 April 2019.

This was the first inspection at the practice under their current registration with CQC.

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 requires improvement overall and good for all the population groups.

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

  • The practice did not have clear systems and processes to keep patients safe.
  • The practice did not have all of the required emergency drugs in stock to ensure patient safety.
  • The practice did not have an adequate system in place to safely manage MHRA and other safety alerts.
  • Staff immunisations were not being safely monitored.
  • The practice had over 500 patient notes which had not been summarised dating back to 1984. This had not been picked up by the practice prior to our inspection and posed a risk to patient safety.
  • Some of the risk assessments in place in the dispensary did not provide enough information to safely mitigate any identified risks.

We rated the practice as good for providing effective, caring and responsive services because:

  • Patients received effective care and treatment.
  • Screening and immunisation data for the practice was good.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

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

  • Leaders could not show that they had the capacity and skills to deliver high quality, sustainable care.
  • The overall governance arrangements were ineffective due to areas of risk which had not been identified prior to our inspection.
  • The practice did not have clear and effective processes for managing risks.

The areas where the provider must make improvements are:

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

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Ensure blind chords in the waiting room are safe and do not pose any risks to patients.
  • Review staff training needs and ensure staff have the skills, knowledge and experience to carry out their roles.

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