Lakeside Healthcare Corby

Lakeside Healthcare Partnership (Lakeside at Corby) had been inspected previously on the following dates:-

26 November 2018 as part of our inspection programme.

At the inspection in November 2018 the practice was rated as requires improvement overall. We rated the practice inadequate for providing safe services, good for effective and caring services and requires improvement for responsive and well-led services. This affected all population groups so we rated all population groups in the responsive domain as requires improvement.

A breach of legal requirements was found in relation to governance arrangements within the practice. A Warning notice was issued which required them to be compliant by 31 January 2019. Lakeside Healthcare Partnership (Lakeside at Corby) submitted an action plan on how they were going to meet the requirements of the warning notice.

We carried out a further announced comprehensive inspection at Lakeside Healthcare Partnership (Lakeside at Corby), on 22 May 2019.

Our judgement of the quality of care at this service is based 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:-

• Lakeside Healthcare Partnership (Lakeside at Corby) demonstrated they had been responsive to the findings of the previous report and were able to evidence significant improvements had been made. We saw clinical leadership and oversight had been improved and GP partners and practice staff we spoke with had been fully engaged in the changes that had been made.
• We spoke with external partners, for example, NHS Nene Clinical Commissioning Group who told us the practice had been engaged and had supported the practice where appropriate.
• The practice had reliable systems for appropriate and safe handling of medicines.
• Patients’ health was now monitored in a timely manner to ensure medicines were being used safely and followed up on appropriately.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had made improvements to their governance arrangements and had taken some of the appropriate steps required to ensure patients remained safe. Further time was required to ensure all the improvements were embedded.

At the inspection in November 2018 and at this inspection we identified an area of outstanding practice.

• Lakeside Healthcare Partnership, as a provider, had their own designated safeguarding team who were employed within the partnership from Monday to Friday to cover all aspects of the safeguarding processes to protect both children and adults. The team covered all aspects of the safeguarding role with a view that this increased staff’s knowledge of at risk patients and ensured a level of continuity. The members of the team were easily contactable during working hours via telephone or the task system on the clinical record system. Staff told us, and we found evidence, that as dealing with safeguarding concerns was the only role of the dedicated team that this enabled them to produce much more detailed safeguarding referrals and child protection reports.

The areas where the provider should make improvements are :-

• Ensure Significant Event Analysis, complaints and patient safety alerts are regularly discussed at nurse and pharmacy meetings.
• Ensure a signed signature sheet is kept with each Patient Group Directive.
• Embed the new clinical oversight model for nurse clinical supervision and competence and ensure debriefs are minuted.
• Improve the identification of carers to enable this group of patients to access the care and support they require.
• Continue to work to improve and review patient satisfaction and respond to reviews where appropriate

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

We carried out an announced comprehensive inspection at Lakeside Healthcare Partnership (Lakeside at Corby), on 26 November 2018 as part of our inspection programme.

Our judgement of the quality of care at this service is based 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.

We rated the practice as inadequate for providing safe services because:

• The practice did not always have clear systems and processes to keep patients safe.
• Staff did not have all the information they needed to deliver safe care and treatment.
• The practice did not have appropriate systems in place for the safe management of medicines.

We rated the practice as good for providing effective services because:

• Patients received effective care and treatment that met their needs.

We rated the practice as good for providing caring services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

We rated the practice as requires improvement for providing a responsive service because:

• Feedback from patients relating to access to services was significantly lower when compared with local and national averages. The practice were aware of this and were implementing an action plan to address the issues.

This area affected all population groups so we rated all population groups as requires improvement.

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

• There were not always clear responsibilities, roles and systems of accountability to support good governance and management.
• The practice did not always have clear and effective processes for managing risks.
• The practice did not always act on appropriate and accurate information.

We identified an area of outstanding practice:

• Lakeside Healthcare Partnership, as a provider, had their own designated safeguarding team who were employed within the partnership from Monday to Friday to cover all aspects of the safeguarding processes to protect both children and adults. The team covered all aspects of the safeguarding role with a view that this increased staff’s knowledge of at risk patients and ensured a level of continuity. The members of the team were easily contactable during working hours via telephone or the task system on the clinical record system. Staff told us, and we found evidence, that as dealing with safeguarding concerns was the only role of the dedicated team that this enabled them to produce much more detailed safeguarding referrals and child protection reports.

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).

In addition, the provider should:

• Review the arrangements for the oversight of nurses’ clinical decision making and ensure the planned system is embedded.
• Review the system for identifying patients with an underlying condition who were eligible for relevant vaccinations to ensure they are regularly identified.

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

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice