7 September 2021
Apsley Surgery is located in Stoke-on-Trent and provides services from their main practice at Cobridge Community Health Centre, Church Terrace, Stoke-on-Trent, Staffordshire, ST6 2JN. The practice also has a branch location at 62 Knypersley Road, Norton, Stoke on Trent, ST6 8HZ. Both sites have good transport links and there are pharmacies nearby.
The provider is registered with the CQC to deliver the Regulated Activities relating to diagnostic and screening procedures, treatment of disease, disorder or injury, maternity and midwifery services and surgical procedures. These are delivered from both sites. The practice offers services from both a main practice and a branch surgery. Patients can access services at either surgery.
The practice is situated within the Stoke on Trent Clinical Commissioning Group (CCG) and delivers General Medical Services (GMS) to a patient population of about 7461.
The practice employs a Lead GP partner and four long-term sessional GPs, nurse practitioners a Lead practice nurse and practice nurse, a diabetic nurse specialist, two pharmacists, three health care support assistants. The clinical team is supported by a practice business director, who is a non-clinical partner, a practice manager and assistant practice manager, administrative staff and receptionist staff covering a range of hours. The team of GPs provide cover at both sites. The practice nurses provide nurse led clinics for long-term condition of use of both the main and the branch locations. The practice Director, practice manager and assistant practice manager are based at the main location to provide managerial oversight.
The practice area is one of very high deprivation when compared with the national and local CCG area. Demographically 24.9% of the practice population is under 18 years old which is higher than the national average of 20.6% and 11.9% are aged over 65 years which is lower the national average of 17.4%. The general practice profile shows that the percentage of patients with a long-standing health condition is 45.6% which is lower than the local CCG average of 55% and the national average of 51%.
The National General Practice Profile describes the practice ethnicity as being 76.2% white British, 16% Asian, 2.9% black, 3.1% mixed and 1.8% other non-white ethnicities. Average life expectancy is 75 years for men and 80 years for women compared to the national average of 79 and 83 years respectively. The practice provided demographic information which demonstrated the current ethnicity of its diverse registered patient population.
The practice is part of a wider network of GP practices Primary Care Network.
Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, many GP appointments are currently telephone consultations. If the GP or nursing team needs to see a patient face-to-face then the patient is offered a choice of either the main GP location or the branch surgery.
Extended access is provided locally provided by North Staffordshire GP Federation, where late evening and weekend appointments are available. Out of hours services are provided by Staffordshire Doctors Urgent Care, accessed via NHS 111.
Further information regarding the practice can be found on the practice website: www.apsleysurgery.co.uk
7 September 2021
We carried out an announced inspection at Apsley Surgery on 12 August 2021. Overall, the practice is rated as Good.
Safe - Good
Effective - Good
Caring - Good
Responsive - Good
Well-led - Good
After our previous inspection at Apsley Surgery on January 2021, the practice was rated Inadequate overall and for the Safe and Well Led domains, Caring was rated good and the Effective and Responsive domains rated as requires improvement. The service was placed into special measures. Services placed in special measures are inspected again within six months. The full reports for previous inspections can be found by selecting the ‘all reports’ link for Apsley Surgery on our website at www.cqc.org.uk
Why we carried out this inspection
This inspection was a comprehensive follow-up with a site visit to for a service placed into special measures and to follow up on the breaches of regulations found at the last inspection in January 2021 at Apsley Surgery. The focus of inspection included:
- Follow up of a Warning Notice breach in Regulation 17 HSCA (RA) Regulations 2014
- Follow up on a Requirement Notice breach in Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment.
- Four best practice recommendations
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 inspection differently.
This inspection was carried out in a way which enabled us to spend a shorter amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.
- Conducting staff interviews using video conferencing
- Completing remote clinical searches on the practice’s patient records system and discussing findings with the provider
- Remotely reviewing patient records to identify issues and clarify actions taken by the provider
- Requesting evidence from the provider
- A shorter site visit
- Conducting remote discussions with the practice Patient Participation Group
- Speaking with four staff who work within care home settings were residents receive a GP service from Apsley Surgery.
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 Good overall and Good for all population groups with the exception of Families, children and young people which was rated as requires improvement.
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 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.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
Whilst we found no breaches of regulations, the provider should:
- Continue to improve the carer register
- Continue to improve cervical and cancer screening uptake
- Consider measures to improve the uptake of childhood immunisations
- Consider a review of the oxygen cylinder size at the branch site based on recent ambulance time to arrival
- Gain advice on whether the use of the adult defibrillator pads are suitable for use on children if required
- Lead GP to continue to progress the Care Quality Commission application to be the Registered Manager.
I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.
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