• Doctor
  • GP practice

The Hythe Medical Centre

Overall: Good read more about inspection ratings

Rochester Road, Staines, Middlesex, TW18 3HN (01784) 454965

Provided and run by:
Dr Mobin Salahuddin

All Inspections

6 July 2023

During a monthly review of our data

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

30 July 2019

During an annual regulatory review

We reviewed the information available to us about The Hythe Medical Centre on 30 July 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

09 June 2016

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

Following an announced comprehensive inspection of The Hythe Medical Centre in December 2015 the practice was given an overall rating of requires improvement.

The practice was rated as requires improvement for providing safe and well-led services, and good for providing caring, effective and responsive services. In addition, all six population groups were rated as requires improvement. At our inspection we identified concerns relating to building and equipment safety checks, the provision of emergency equipment, recruitment and appraisal of staff. we also had concerns in respect of the recording, analysis, and sharing of learning from significant events.

After the comprehensive inspection, the practice wrote and provided an action plan to tell us what they would do in respect of our inspection report findings and to meet legal requirements. We undertook this focused inspection on 9 June 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. Overall the practice is rated as good following this inspection.

Our previous inspection in December 2015 found the following areas where the practice must improve:

  • Improve staff understanding and the subsequent recording of significant events and the communication of any learning points to appropriate staff.

  • Ensure that oxygen is available to deal with medical emergencies.

  • Ensure that building safety checks are completed, including electricity safety checks, legionella risk assessments and the routine testing of fire alarms and fire drills.

  • Ensure that portable electrical safety testing is carried out and that clinical equipment is calibrated.

  • Ensure that infection control audits are completed regularly and any subsequent concerns actioned.

  • Ensure the annual appraisal process is robust and that all staff have annual appraisals.

  • Ensure that recruitment checks are completed in line with practice policies.

  • Implement a schedule of clinical audit to support improvement.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

Our key findings across the areas we inspected for this focused inspection were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting, recording, investigating and sharing learning from significant events.
  • Risks to patients were assessed and well managed including building and equipment safety checks and infection control audits.
  • The practice had good facilities and was well equipped to treat patients and meet their needs including the management of patient confidentiality in the waiting area and provision of oxygen to deal with medical emergencies.
  • There was a system in place for annual appraisals and all staff had an appraisal within the last twelve months.
  • Recruitment checks for new staff were completed in line with practice policy.
  • There was a clear schedule of clinical audit used to drive quality improvement.

As a result of this inspection, the areas where the provider should make improvement are:

  • Review the results of the national GP survey and consider ways that the practices performance could be improved, specifically in areas where the survey results are below average.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

17 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Hythe Medical Centre on 17 December 2015. Overall the practice is rated as requires improvement.

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.
  • Patients were at risk of harm because systems and processes were not in place to keep them safe. For example appropriate building safety checks had not been undertaken.

  • 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 said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patients gave us examples where the GP had gone over and beyond for his patients such as late evening home visits.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice had a number of policies and procedures to govern activity.
  • 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 improvement are:

  • Improve staff understanding and the subsequent recording of significant events and communication of any learning points to appropriate staff.

  • Ensure that oxygen is available to deal with medical emergencies.

  • Ensure that building safety checks are completed including electricity safety checks, legionella risk assessments and the routine testing of fire alarms and fire drills.

  • Ensure that portable electrical safety testing is carried out and that clinical equipment is calibrated.

  • Ensure that infection control audits are completed regularly and any subsequent concerns actioned.

  • Ensure the annual appraisal process is robust so that all staff have annual appraisals.

  • Ensure that recruitment checks are completed in line with practice policies.

  • Implement a schedule of clinical audit to support improvement.

The areas where the provider should make improvements are:

  • Review how patient confidentiality in the reception area is maintained.

  • Review the results of the national GP survey and ways that the practices performance could be improved in areas where results are below average.

  • Review the facilities available for patients with hearing impairments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice