We carried out an announced inspection at Newgate Medical Group between 14 and 16 September 2021. Overall, the practice is rated as requires improvement.
Safe - requires improvement
Effective - requires improvement
Caring - good
Responsive - requires improvement
Well-led - good
Following our previous focused inspection on 24 July 2019, the practice was rated requires improvement overall and for the effective and well-led key questions, and rated good for the responsive key question. We did not inspect the safe and caring key questions during that inspection.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Newgate Medical Group on our website at www.cqc.org.uk.
Why we carried out this inspection
This inspection was a comprehensive inspection to follow up on previous breaches of regulation.
How we carried out the inspection/review
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 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
- A site visit
- Conducting an electronic staff questionnaire
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 improvement overall and for all population groups.
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.
- The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
However:
- Not all staff had completed safeguarding training to appropriate levels for their role.
- The practice’s systems for the appropriate and safe use of medicines, including medicines optimisation, required review.
- The practice’s process for management of medicine safety alerts required review.
- The practice was not meeting its target for childhood immunisation rates or cervical smear uptake.
- Telephone access and appointment booking processes required further improvement.
We found several areas of outstanding practice:
- The provider had assigned a dedicated GP to provide weekly cover at a large local school, which allowed children and young people to receive care, treatment and medical advice whilst at school.
- The practice employed reception staff who could speak other languages commonly spoken by the local community. This allowed patients to communicate directly with the practice in their own language without the need of an interpreter or translator.
- The practice had developed strong working relationships with several voluntary organisations and charities to allow patients, their families and their carers to receive dedicated help, advice and support.
- The practice participated in several local and national pilots, including a national diabetes reversal pilot and a national weight management pilot.
We found one breach of regulations. The provider must:
- Ensure care and treatment is provided in a safe way to patients.
Although not a breach of regulations, the provider should:
- Improve telephone access to the practice for patients.
- Implement a robust system for the rechecking of staff professional registrations.
- Improve the management of the disposal of sharps bins.
- Improve childhood immunisation and cervical screening rates.
- Implement a robust system for alerting Public Health England of any notifiable diseases.
- Improve systems to identify carers.
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