During an assessment under our new approach
Date of assessment: 14-16 October 2024. Remote clinical searches were carried out on 14 and 16 October 2024. A site visit took place on 16 October 2024.
Tottenham Health Centre is located at 759 High Road, Tottenham, London, N17 8AH. The practice is situated a short walking distance from White Hart Lane underground station and is also accessible on several local bus routes. The practice is registered with the CQC to provide the Regulated Activities: Diagnostic and screening procedures; Family planning; Maternity and midwifery services; and Treatment of disease, disorder or injury. The practice is part of the North Central London Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of about 5800.
The practice clinical staff included two GP partners, two long-term locum GPs, a practice nurse, a physician associate, a health care assistant, and a clinical pharmacist. Other practice staff included a practice manager, an assistant practice manager, a medical secretary, a care coordinator, and four members of the reception team. The practice was open 8am to 6.30pm, Monday to Friday. Patients could also book appointments at three local extended hours GP Hubs Monday to Friday 6.30pm to 8.30pm, and Saturday and Sunday 8am to 8pm. For out of hours services, people were directed to NHS 111 or 999 for an emergency.
We inspected and rated this service under our previous methodology on 4 October 2022. At that inspection it was rated as good overall. The key questions for safe, responsive, caring and well led were rated good, and effective was rated as requires improvement. Due to concerns identified in effective, we issued a requirement notice (now known as an action plan).
The requirement notice highlighted that the practice had a number of gaps in recruitment files and staff did not always have the appropriate level of safeguarding training applicable to their role.
In July 2024, we received concerns from the Integrated Care Board regarding safeguarding matters not being identified and actioned in a timely manner.
Taking the previous requirement notice and information received from the ICB we decided to carry out a responsive inspection.
We carried out this assessment using our single assessment framework between 14-16 October 2024. The clinical remote searches were completed by our GP Specialist Advisor on 14 and 16 October 2024. We carried out a site visit with two CQC inspectors and a nurse specialist advisor. We assessed all the quality statements for safe, effective and well led. We assessed one quality statement in responsive, and we did not assess the caring key question.
At this inspection, we found that the issues highlighted in the previous inspection had been addressed appropriately. However, we identified new concerns regarding the safe and appropriate management of medicines and lack of good governance (explained in detail below).
As a result of this inspection, we rated the practice as requires improvement in safe, effective and well led. We carried over the good ratings for caring and responsive from the previous inspection. This gave the practice a new overall rating of requires improvement.
We also issued a notice of action plan for breaches of Regulation 12 Safe Care and Treatment, and Regulation 17 Good Governance. An action plan notice gives the practice an opportunity to address the concerns identified by a specified date, after which we will carry out a further assessment to review whether appropriate action has been taken.