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Higham Ferrers Surgery Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 May 2020

The practice was inspected in April and December 2018, they were rated requires improvement and inadequate at these inspections respectively. In January 2019, we inspected the practice again to ensure that improvements had been made and found that although improvements had been made, there were other concerns identified and the practice was placed into special measures.

We carried out an announced comprehensive inspection at Higham Ferrers Surgery on 26 February 2020. We also followed up on a warning notice that was issued to the practice for a breach of regulation 17(1) identified at the previous inspection in June 2019 and to ensure that the practice was now compliant with the regulations of the Health and Social Care Act 2012.

At the last inspection in June 2019 we rated the practice inadequate for providing safe, and well-led services because:

  • Systems in place to manage and mitigate risks were not effective. In particular in relation to recruitment, safety alerts, high-risk medicines and prescriptions.
  • There was a lack of consistent management and the practice failed to demonstrate that improvements could be sustained.

At the last inspection in June 2019 we rated the practice requires improvement for providing effective, caring and responsive services because:

  • Care and treatment was not being delivered effectively due to concerns over high-risk medicines.
  • Because they had failed to demonstrate that changes had been made to address the needs of the population.
  • Patient feedback had not been fully considered to make improvements for patients.

At this inspection, we found that the provider had satisfactorily addressed most of these areas, but other concerns were identified.

We based our judgement on the quality of care at this service is 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. The practice is rated as requires improvement in the safe and well-led key questions.

We rated the practice requires improvement for providing safe services because:

  • We saw that improvements had been made in relation to prescriptions, recruitment procedures and medicine safety alerts but other gaps were identified. These were in relation to systems in place to identify and mitigate risks. The practice management team had been in place since July 2019 and had established new systems, but these were not yet fully embedded or working as intended.

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

  • We had seen improvements in the establishment of a two-member management team who had worked comprehensively to address the concerns raised at the previous inspection; newly established systems and processes were not yet fully embedded or working as intended. Gaps and other concerns were identified, and the practice acknowledged that further work was needed.

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

  • We saw that improvements had been made to the monitoring of patients on high-risk medicines. Following the inspection, the practice was able to show us that further concerns that were identified in relation to the consistency and accuracy of information being used to monitor these patients was satisfactorily resolved.
  • Cervical screening and Childhood immunisation uptake results showed improvements.
  • Although patient satisfaction scores on the national patient survey were still low, the practice had taken actions to address these concerns and had conducted their own survey, unverified data from which, indicated that satisfaction had begun to improve.
  • Access to services did not always support positive outcomes for patients, we saw that some actions had been taken. Unverified data provided by the practice indicated that patient’s satisfaction had begun to improve.

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).

The areas where the provider SHOULD make improvements are;

  • Ensure that clinical waste bins are stored securely, within a designated clinical waste area.
  • Improve checklists for emergency equipment to ensure levels and working status are checked.
  • Improve cervical screening uptake results.
  • Continue to take action to ensure that patient satisfaction increases.
  • Review access for patients outside of working hours to support patient services.

I am taking this service out of special measures. This recognises the 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

Inspection areas

Safe

Requires improvement

Well-led

Requires improvement
Checks on specific services

People with long term conditions

Good

Families, children and young people

Good

Working age people (including those recently retired and students)

Good

People experiencing poor mental health (including people with dementia)

Good

People whose circumstances may make them vulnerable

Good