The Care Quality Commission
  • Doctor
  • GP practice

Doctors Hardy, Hughes, Harvey and Roberts Also known as The Hungerford Medical Centre

Overall: Good read more about inspection ratings

Hungerford Medical Centre, Crewe, Cheshire, CW1 5HA (01270) 275949

Provided and run by:
Hungerford Medical Centre

All Inspections

10 October

During a routine inspection

We carried out an announced comprehensive inspection at Doctors Hardy Hughes Harvey Roberts (Hungerford Medical Centre) on 10 October 2023. Overall, the practice is rated as good.

Safe - good

Effective - good

Caring - good

Responsive - requires improvement

Well-led - good

During the inspection process, the practice highlighted efforts they are making to improve access for their population. These had only recently been implemented so there is not yet verified evidence to show they were working. However, we continue to monitor the data and where we see potential changes, we will follow these up with the practice.

Following our previous inspection on 24 August 2022, the practice was rated requires improvement overall and for all key questions but caring and responsive which were rated good.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Doctors Hardy Hughes Harvey Roberts on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from a previous inspection.

We inspected the key questions of: Safe, effective, caring, responsive and well-led.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A short site visit.

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, patients, the public and other organisations.

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Responsive is rated requires improvement because:

  • Patients reported less satisfaction with access to the practice in the National GP Patient Survey, directly to CQC and to the practice. The provider was in progress with an action plan to improve the appointment system and was monitoring patient feedback. The changes to the systems were yet to be fully implemented, evaluated over time and sustained.

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

  • Take action to maintain staff vaccination records if relevant to role.
  • Review the processes for monitoring patients’ health in relation to the use of medicines including medicines that require monitoring.
  • Take action to review the system for management and monitoring of historic safety alerts.
  • Take action to address monitoring and follow up action required for patients with long term conditions.
  • Monitor and continue to take action to improve uptake for cervical screening.
  • Put in place a written programme of quality improvement and audits.
  • Continue to take action to improve patient satisfaction regarding access to the service.
  • Review documentation and sharing of information from practice meetings with the staff team to facilitate effective learning and communication.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care

24 August 2022

During an inspection looking at part of the service

We carried out an announced inspection at Doctors Hardy, Hughes, Harvey and Roberts (Also known as The Hungerford Medical Centre) on 24 August 2022. Overall, the practice is rated as requires improvement.

The key questions are rated as:

Safe – Requires improvement

Effective – Requires improvement

Caring – Good (rating awarded at the inspection October 2016)

Responsive – Good (rating awarded at the inspection October 2016)

Well-led – Requires improvement

The provider was last inspected October 2016 and was rated Good overall and in all the key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Doctors Hardy, Hughes, Harvey and Roberts on our website at www.cqc.org.uk

Why we carried out this inspection

We undertook this inspection as part of a random selection of services rated good and outstanding to test the reliability of our new monitoring approach. This included focusing on the key questions safe, effective and well led. Caring and responsive were not inspected.

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 inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews by telephone and using video conferencing
  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider
  • Reviewing patient records to identify issues and clarify actions taken by the provider
  • Requesting evidence from the provider
  • Gaining feedback from staff using staff questionnaires
  • A shorter site visit

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, patients, the public and other organisations.

We have rated this practice as requires overall

We found that:

  • The practice in the main provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients in the main received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.

Following this inspection, we have rated the practice requires improvement for providing safe services. We identified recruitment checks were not carried out in accordance with regulations and staff did not always have the information to deliver safe care and treatment.

Following this inspection, we have rated the practice requires improvement for providing effective services as not all staff received effective induction, appropriate support, training and appraisal.

Following this inspection, we have rated the practice requires improvement for delivering well-led services. The practice was unable to demonstrate they had robust systems in place to assess, monitor and mitigate the risks of services delivered.

We found three breaches of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.

The provider should also:

  • Have systems in place to gather satisfactory evidence of conduct in previous employment, such as references, and maintain a copy proof of identity including a recent photograph within staff files.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

11 October 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hungerford Medical Centre on 11 October 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Significant events had been investigated and action had been taken as a result of the learning from events.
  • Systems were in place to deal with medical emergencies and all staff were trained in basic life support.
  • There were systems in place to reduce risks to patient safety. For example, infection control measures were carried out.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • Feedback from patients about the clinical care and treatment they received was very positive.
  • Data showed that outcomes for patients at this practice were similar to locally and nationally reported outcomes.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Staff felt well supported in their roles and were kept up to date with appropriate training.
  • Patients said they had confidence in the practice, were treated with dignity and respect and they were involved in decisions about their care and treatment.
  • Overall, patients told us the appointments system was flexible and they could get an urgent appointment when they needed one. However, a proportion of patients told us they had difficulty in booking a routine appointment.
  • The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.
  • Information about services and how to complain was available. Complaints had been investigated and responded to in a thorough, sensitive and timely manner.
  • The practice had a clear vision to provide a safe and high quality service.
  • There was a clear leadership and staff structure and staff understood their roles and responsibilities.
  • The practice provided a range of enhanced services to meet the needs of the local population.
  • The practice sought patient views about improvements that could be made to the service. This included the practice having and consulting with their patient participation group (PPG).

We saw one area of outstanding practice:

  • The comprehensive method of collating, managing and actioning safeguarding information.

The areas where the provider should make improvement are:

  • Review the system for booking routine appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice