The Vine House Health Centre

Updated 10 January 2022

The Vine House Health Centre provides a range of primary medical services from its premises at 87 – 89 High Street, Abbots Langley, Hertfordshire, WD5 0AL. The practice is part of the Watford Extended Access GP federation. The practice is also in the early stages of participating in a Primary Care Network (PCN). (A Primary Care Network is a group of practices working together to provide more coordinated and integrated healthcare to patients).

The provider is registered with CQC to deliver five Regulated Activities. These are: diagnostic and screening procedures; maternity and midwifery services; family planning services; surgical procedures; and treatment of disease, disorder or injury.

Services are provided on a General Medical Services (GMS) contract (a nationally

agreed contract) to approximately 12000 patients. The practice has a registered manager in place. (A registered manager is an individual registered with CQC to manage the regulated activities provided).

The practice is within the Hertfordshire local authority and is one of 59 practices serving the NHS Herts Valleys Clinical Commissioning Group (CCG).

The practice team consists five GP partners and one salaried GP. There are four practice nurses, a healthcare assistant, a phlebotomist, a practice manager, a deputy practice manager, two secretaries, five administration staff and 10 reception staff.

The practice serves a slightly above average population of those aged 65 years and over. The practice population is predominantly white British and has a Black and minority ethnic (BME) population of approximately 8.5%. Information published by Public Health England rates the level of deprivation within the practice population as nine. This is measured on a scale of one to 10, where level one represents the highest levels of deprivation and level 10 the lowest.

An out of hours service for when the practice is closed is provided by Herts Urgent Care and can be accessed via the NHS 111 service.

Updated 10 January 2022

We carried out an announced inspection at The Vine House Health Centre on 9 December 2021 Overall, the practice is rated as good.

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

Following our previous inspection on 2 October 2019, the practice was rated good overall; however, we found a breach of regulations which meant the practice was rated requires improvement for providing safe services.

The full reports for the October 2019 inspection can be found by selecting the ‘all reports’ link for The Vine House Health Centre on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a desk-based review to follow up on required actions identified at the last inspection as part of the key question providing safe services.

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 included

• Requesting evidence from the provider
• Information from our ongoing monitoring of data about services.

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.

We have rated this practice as good for providing safe services because:

We found that:

• Systems were in place to ensure staff were given the appropriate authorisations to administer medicines (Including Patient Group Directions or Patient Specific Directions).
• Systems were in place to ensure staff were trained to appropriate levels for their role.
• Staff had received vaccinations in line with their role in accordance with guidance.
• The infection prevention and control lead had completed additional infection control training beyond the essential training completed by all staff.

Additionally, where we previously told the practice they should make improvements our key findings were as follows:

At the previous inspection the uptake for one childhood immunisation was below the 90% minimum target. The uptake for this childhood immunisation remains below the target at 83%. However, systems were in place to book people in for subsequent appointments with protected time allocated to staff to monitor and chase outstanding appointments. Additional clinics have been set up to ensure children without proof of immunisations are immunised.

At the previous inspection the uptake of appointments for women attending their cervical screening was below the 80% minimum target. The uptake for women attending their cervical screening remains below target at 76%. However, plans to increase capacity for smear appointments are in place via staff training with more available time slots for appointments, assistance is offered to reduce communication barriers and reminder letters are sent out if appointment is not attended.

Staff at the practice have now been issued with an electronic training profile which allows for improved monitoring of staff training, alerts are sent to remind individuals when a module is reaching expiry and needs to be renewed. We were sent a copy of the care certificate for the Health Care Assistant.

At the previous inspection we told the provider they should provide staff with access to a Freedom to Speak Up Guardian and encourage an understanding of the practice’s values and strategy among all practice staff. A relevant poster with this information is now visible to all staff and further information is available to staff in the whistle-blowers protocol.

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

Continue with actions to increase the uptake of childhood immunisations and women attending for cervical screening.

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