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Inspection Summary


Overall summary & rating

Good

Updated 9 December 2019

We carried out an announced comprehensive follow up inspection at Hungerford Surgery on 31 October 2019 as part of our inspection programme. We last inspected Hungerford Surgery on 25 September 2018 and we rated the practice Requires Improvement overall, with safe, effective and well-led rated as requires improvement. As a result of that inspection, two requirement notices were issued for breach of Regulation 17 (good governance) and Regulation 18 (staffing).

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.

Following this inspection, we have rated the practice as Good overall, but Requires Improvement for providing Effective services. Two out of six population groups have also been rated Requires Improvement.

We found that:

  • The practice had made improvements to its oversight of monitoring of staff training.
  • The practice now had a clear process in place for uncollected prescriptions and patients who had not collected prescriptions were followed up.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • Staff feedback had improved and was positive and staff felt their concerns and suggestions were appropriately addressed.
  • Practice policies were fully embedded, and the practice had a process to ensure policies were appropriately reviewed.
  • The practice sought assurances that locum GPs had appropriate checks and training carried out prior to working at the practice.
  • Appropriate risk assessments had been carried out and acted upon in a timely manner.
  • The practice was taking appropriate steps to improve its uptake of cervical screening and childhood immunisations.
  • The practice had improved its security for blank prescriptions and was adequately logged and monitored. However, the practice policy did not reflect national guidance for security of blank prescriptions taken on home visits.
  • The practice was monitoring performance to improve outcomes for patients. However, there was limited monitoring of the outcomes in relation to exception reporting rates.

The practice was previously rated as Requires Improvement for the Effective domain. Although we saw significant improvement to the concerns raised around staff training at the last inspection, we continued rated the practice as Requires Improvement for providing effective services because:

  • The practice had high exception reporting in some areas which were higher than local and national averages and the practice monitoring of exception reporting had not identified these as areas to review.

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

  • Review practice policy for prescription security in line with national guidance to minimise potential loss when attending home visits.
  • Review methods for monitoring exception reporting rates to improve practice performance to be in line with local and national averages.
  • Continue to take steps to improve cervical screening and childhood immunisation results.

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

Requires improvement

Caring

Good

Responsive

Good

Well-led

Good
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)

Requires improvement

People whose circumstances may make them vulnerable

Good