• Doctor
  • GP practice

Highbury Grange Medical Practice

Overall: Good read more about inspection ratings

Highbury Grange Health Centre, 1-5 Highbury Grange, London, N5 2QB (020) 7226 2462

Provided and run by:
Highbury Grange Medical Practice

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Highbury Grange Medical Practice 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 Highbury Grange Medical Practice, you can give feedback on this service.

11 March 2020

During a routine inspection

We carried out an announced comprehensive inspection at Highbury Grange Medical Practice, on 5 March 2019, and rated the practice as inadequate for safe, requires improvement for well-led and good for effective, caring; and responsive. This gave the practice an overall rating of requires improvement. The full comprehensive report on the March 2019 inspection can be found by selecting the ‘all reports’ link for Highbury Grange Medical Practice on our website at . Because of the safety concerns we identified in managing and monitoring patients on high-risk medicines, we served a warning notice under Section 29 of the Health and Social Care Act 2008, as the provider was failing to comply with the relevant requirements of Regulation 12, (1), Safe care and treatment, of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At the inspection, on 5 March 2019

  • We rated safe as inadequate because the practice had not provided care and treatment in a way that kept patients safe. In particular, we found there was unsafe and inappropriate management and monitoring of patients prescribed high-risk medicines. We also found concerns regarding the accuracy of the practice’s safeguarding register and there was not a safe system for monitoring patients referred under the two-week wait cancer referral service.
  • We rated well-led as requires improvement because there was a lack of systems and processes established and operated effectively to identify or manage the above issues.

We carried out a warning notice follow-up inspection, on 18 July 2019, to assess whether the concerns identified in the warning notices had been addressed by the provider. At that inspection we found that the provider had appropriately addressed all the concerns identified in the warning notices and was providing safe care to patients on high-risk medicines.

We carried out a focused inspection, on 24 October 2019, the inspection focused on the safe and well-led key questions. At that inspection, we were satisfied the practice had addressed all previous concerns and we rated safe and well-led as good.

This inspection was carried out remotely on 11 March 2020. The lead inspector conducted a telephone interview with the practice manager. We determined the rating of all five key questions using a combination of evidence provided during the telephone interview, pre-inspection information sent by the practice, and the evidence collected from the three previous inspections held in 2019.

We rated the practice as good for providing safe, effective, caring, responsive and well-led services. This gave the practice an overall rating of good.

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 rated the practice as good for providing safe services because:

  • The practice provided care and treatment in a way that kept patients safe and protected them from avoidable harm.
  • There was safe and effective monitoring and management of patients that were prescribed high-risk medicine.
  • There was safe and effective monitoring of patients referred under the two-week cancer referral system.
  • There was safe and effective monitoring of patients on the child safeguarding register.

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

  • Patients received effective care and there was a strong emphasis on continuous improvement.

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 good for providing responsive services because:

  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

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

  • Systems and processes had been established and operated effectively to ensure compliance with requirements to demonstrate good governance and safe care and treatment.

We rated all the population groups as good, except for working age people which we rated as requires improvement, this is because the practice cervical screening uptake rate was well below the national target of 80%.

The areas where the provider should make improvements are:

  • Continue with efforts to improve the up-take of cervical screening.
  • Continue with efforts to improve the up-take childhood immunisations.

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

24 October 2019

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Highbury Grange Medical Practice on 5 March 2019 and rated the practice as inadequate for safe; good for effective, caring and responsive and requires improvement for well-led. This gave the practice an overall rating of requires improvement.

At the inspection, on 5 March 2019:

  • We rated safe as inadequate because the practice had not provided care and treatment in a way that kept patients safe. In particular, we found there was unsafe and inappropriate management and monitoring of patients prescribed high-risk medicines. We also found concerns regarding the accuracy of the practice’s safeguarding register and there was not a safe system for monitoring patients referred under the two-week wait cancer referral service.
  • We rated well-led as requires improvement because there was a lack of systems and processes established and operated effectively to identify or manage the above issues.

Following our inspection, on 5 March 2019, we served a warning notice under Section 29 of the Health and Social Care Act 2008 because the provider was failing to comply with the relevant requirements of Regulation 12, (1), Safe care and treatment, of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The full comprehensive report on the March 2019 inspection can be found by selecting the ‘all reports’ link for Highbury Grange Medical Practice on our website at .

We carried out a warning notice follow up inspection, on 18 July 2019, to assess whether the concerns identified in the warning notice had been addressed by the provider. At that inspection we found that the provider had appropriately addressed all the concerns identified in the warning notice. The warning notice report can also be found by selecting the ‘all reports’ link for Highbury Grange Medical Practice on our website at www.cqc.org.uk.

At this inspection, we carried out an announced focussed inspection reviewing the safe and well-led domain. We found all the issues identified previously had been addressed to an appropriate standard. We have now rated the practice as good in safe and well-led.

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 rated the practice as good for providing safe services because:

  • The practice now provided care and treatment in a way that kept patients safe and protected them from avoidable harm.
  • There was safe and effective monitoring and management of patients that were prescribed high-risk medicine.
  • There was safe and effective monitoring of patients referred under the two-week cancer referral system.
  • There was safe and effective monitoring of patients on the child safeguarding register.

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

  • Systems and processes had been established and operated effectively to ensure compliance with requirements to demonstrate good governance and safe care and treatment.

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

18 July 2019

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Highbury Grange Medical Practice on 5 March 2019. At that inspection we the rated the practice as; Inadequate for safe; Good for effective, caring and responsive; and Requires Improvement for well-led. This gave the practice an overall rating of requires improvement. As a result of the safety concerns (unsafe monitoring and management of patients on high-risk medicines) we served a warning notice under Section 29 of the Health and Social Care Act 2008, as the provider was failing to comply with the relevant requirements of Regulation 12, (1), Safe care and treatment, of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The full comprehensive report on the March 2019 inspection can be found by selecting the ‘all reports’ link for Highbury Grange Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 18 July 2019 to confirm the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations we identified in the warning notice issued after the March 2019 inspection. This report covers our findings in relation to those requirements.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from the provider, patients, the public and other organisations.

We have not re-rated the practice on this occasion. We will consider re-rating the practice when we carry out our follow up inspection, this will be within six months from the publication date of the March 2019 report.

We found that:

  • The practice had addressed all of the issues identified within the warning notice and now provided care and treatment in a way that kept patients safe and protected them from avoidable harm.
  • Comprehensive care records were maintained and there was appropriate management and monitoring for patients administered high-risk medicine.

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

5th March 2019

During a routine inspection

We carried out an announced comprehensive inspection at Highbury Grange Medical Practice on 05 March 2019. The practice was previously rated as good overall in October 2017.

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 improvement overall.

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

  • The service lacked appropriate protocols to ensure the safe prescribing of high-risk medicines.

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

  • The practice did not have clear and effective governance processes for managing and monitoring patients being prescribed high risk medinces; patients being referred under the two week wait cancer referral service; and maintaining the internal child safeguarding register.

We rated the practice as good for providing effective, caring and responsive services because:

  • Patients received effective care and there was a strong emphasis on continuous improvement.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

We rated the practice as good for all population groups.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way (Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Continue with efforts to improve the up-take of cervical screening.
  • Continue with the new process of recording and following up patients who have been referred under two week wait referral service.
  • Continue with the new process for keeping the practice’s safeguarding register up to date and in line with the child protection register.

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

24 October 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Highbury Grange Medical Practice on 18 July 2017. We rated the practice as good for providing effective, caring, responsive and well-led services and the overall rating was good. We rated the practice as requires improvement for providing safe services, as we had concerns relating to infection prevention and control, medicines management and fire safety training for staff.

We served a requirement notice relating to the practice’s failure to comply with Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The full comprehensive report on the July 2017 inspection can be found by selecting the ‘reports’ link for Highbury Grange Medical Practice on our website at http://www.cqc.org.uk/location/1-543975260. After the inspection, the practice sent us a plan of actions it intended to take to ensure it was able to meet the legal requirements under the key question, Safe.

This inspection was an announced focussed inspection carried out on 24 October 2017 looking at the issues previously identified and to check and confirm that the practice had carried out its plan to meet the legal requirements. We found that the practice had taken appropriate action to meet the requirements of the regulations relating to providing a safe service, with regard to the safety issues we had identified. Accordingly, we have revised the practice’s rating in respect of providing a safe service to good.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

18 July 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the Highbury Grange Medical Practice on 18 July 2017. Overall the practice is rated as good.

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

  • Systems, processes and policies were not always reliable to keep people safe. These related to infection prevention and control issues, the use of Patient Group Directions by locum nurses and fire awareness training for staff.
  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Feedback from patients and the results of the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients we spoke with said they found it easy to make an appointment with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the practice must make improvement are:

  • Ensure care and treatment is provided in a safe way to patients. In particular that - appropriate levels of cleanliness are maintained in all areas, with cleaning being carried out in accordance with written schedules to allow monitoring; all staff members receive up to date training in infection prevention and control; Patient Group Directions in respect of locum nurses are completed correctly and validated; and all staff members receive annual fire awareness training.

The area were the practice should make improvement is:

  • Continue with plans to improve and monitor outcomes for patients with long term conditions.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

8 April 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Highbury Grange Medical Practice on 8 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, caring, safe and responsive services. The service was found to require improvement for providing an effective service. It was also good for providing services for the care provided to older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • Risks to patients were assessed and well managed.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • Patients said they were treated with compassion, dignity and respect and that they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • 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.

There were areas of practice where the provider needs to make improvements.

Importantly the provider should:

  • Ensure a programme of completed clinical audit cycles is undertaken.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice