The Care Quality Commission
  • Doctor
  • GP practice

Seaforth Farm Surgery

Overall: Requires improvement read more about inspection ratings

Vicarage Lane, Hailsham, East Sussex, BN27 1BH (01323) 848494

Provided and run by:
Hailsham Medical Group

Important:

We served warning notices on Seaforth Farm Surgery on 4 September 2024 for failing to meet the regulations relating to Safe care and treatment, good governance and staffing.


We imposed conditions on the registration of Seaforth Farm Surgery on 20 August 2025. We found serious concerns that included but was not limited to; safe care, management, and treatment of patients, medicines management, good governance and capable and compassionate leadership.

All Inspections

During an assessment under our new approach

We conducted an unannounced assessment on 7 August 2025 to 12 August 2025 to follow up on compliance with warning notices served on 4 September 2024 and in response to information of concern. The provider was required to be compliant by 6 December 2024.

Seaforth Farm Surgery is a GP practice and delivers services to approximately 11,400 patients under a contract held with NHS England. Services are provided from Seaforth Farm Surgery (main surgery) and Vicarage Field Surgery (branch surgery). We visited both sites during this assessment.

According to the latest available data, the ethnic make-up of the practice area is 96% White, 1.6% Asian, 1.5% Mixed, 0.4% Black and 0.3% other. The age distribution of the practice population closely mirrors the local and national averages. Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 6th decile (6 of 10). The lower the decile, the more deprived the practice population is relative to others. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.

At our last inspection we found the practice was failing to provide safe care and treatment to patients. At this inspection we identified improvements in relation to the management of safety alerts and fire risk assessments. However, insufficient improvements had been made, and additional concerns were identified. We found patients’ health was not always monitored in a way that ensured the safe prescribing of certain medicines. Reviews of patients’ medicines were insufficient. Staff administering and prescribing medicines were not appropriately authorised and those in advanced roles were not properly supervised. Systems for ensuring emergency medicines and equipment were regularly checked and fit for use were ineffective. There was a poor learning culture where staff felt unable to raise concerns. Leaders failed to identify and manage risks; we identified a significant backlog of blood test results which meant patients were put at risk of potential harm.

At our last inspection we found inadequate leadership, management and governance. At this inspection insufficient improvements had been made. Governance processes, which supported the safe delivery of care were still unclear. They failed to promote a positive culture of continuous learning and improvement. Leaders had failed to foster a positive culture where staff felt they could speak up and their voice be heard. Information about risks, performance and outcomes was not used to keep patients safe from harm or shared effectively to improve care.

We found breaches of regulation in relation to safe care, staffing and treatment and good governance. The provider remained non-compliant with the warning notices. We took urgent enforcement action which imposed conditions on the provider’s registration.

 

 

During an assessment under our new approach

Date of assessment: 30 July 2024 to 13 August 2024. Seaforth Farm Surgery is an NHS GP practice located in Hailsham. There were approximately 11,394 people registered with the service at the time of our assessment. We conducted this assessment in response to information of concern. We assessed 11 quality statements across safe, effective and well-led key questions and have combined the scores for these areas with scores from the last inspection. During our assessment we found the practice had not promoted a culture of learning where safety was a priority for everyone. Leaders had not fostered a positive culture where staff felt they could speak up and their voice be heard. The effectiveness of people’s care and treatment was not always maximised. Arrangements for clinical supervision were insufficient. Governance and management systems were ineffective. Information about risks, performance and outcomes was not being used consistently to improve care.

Our findings resulted in breaches of 3 regulations: safe care and treatment, staffing and good governance.

8 July 2022

During an inspection looking at part of the service

We carried out an announced inspection at Seaforth Farm Surgery on 8 July 2022. Overall, the practice is rated as Good.

Following our previous inspection in November 2020, the practice’s previous overall rating and ratings for providing safe, effective, responsive, caring and well-led services were carried over from the previous inspection in 2017. We inspected but did not rate the practice.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Seaforth Farm Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was carried out to follow up on outstanding breaches of regulation:

Regulation 12 Health and Social Care Act (Regulated Activities) Regulations 2014 Safe care and treatment.

Regulation 18 Health and Social Care Act (Regulated Activities) Regulations 2014 Staffing

How we carried out the 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 reviews and inspections differently.

This inspection was carried out in a way which enabled us to review information remotely. This was with consent from the provider and in line with all data protection and information governance requirements. We visited the service as part of our inspection.

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

Our findings

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

  • what we found from our review
  • information from our ongoing monitoring of data about services and
  • information from the provider.

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm. For example, the practice had taken steps to ensure high risk medicines were monitored in accordance with national guidelines. However, there were some instances where blood tests were overdue,
  • Staff were supported by up to date PGDs. We found that PGDs had been signed by all required staff prior to the sign off by the authorising manager.
  • A system of clinical supervision had been introduced to support clinical staff. We received positive feedback on the support provided.
  • The practice recruitment system was in line with regulation.
  • Emergency medicines and stock were up to date.

Whilst we found no breaches of regulations, the provider should:

Continue to take steps to recall patients for appropriate blood tests and follow up reviews.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

29 October 2020

During an inspection looking at part of the service

We carried out an announced focussed inspection at Seaforth Farm Surgery on 29 October 2020 with further remote access inspection activity on 4 November 2020, 25 November 2020 and 26 November 2020. This was in response to concerns raised about the safety of medicine management at this practice.

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.

Our key findings were as follows:

  • At this inspection we identified some concerns around clinical governance.
  • Systems were not in place to provide formal clinical support to staff.
  • Clinical records did not always demonstrate that patients were fully assessed.

The areas where the provider must make improvements are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Ensure staff receive appropriate support, training, professional development, supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Keep the workforce and staff skill mix under review to meet the access and care and treatment needs of the practice population.
  • Keep the significant event analysis process under review to demonstrate all potential learning has been captured and shared.

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

10 August 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice


We carried out an announced focused inspection at Seaforth Farm Surgery on 16 February 2017. Overall the practice was rated as good, however we found a breach of legal requirement and the practice was rated as requires improvement for providing well-led services.

The practice sent us an action plan detailing what they would do to meet the legal requirements in relation to the following:-

  • Ensuring that a system was in place to take account of the views of patients and other stakeholders.
  • Ensuring the establishment of a forum for patients to share views and be involved in the development of the practice.

The full report on the February 2017 inspection can be found by selecting the ‘all reports’ link for Seaforth Farm Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 10 August 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection on 16 February 2017. This report covers our findings in relation to that requirement and also additional improvements made since our last inspection.

Overall the practice is rated as good. Additionally the practice is now rated as good for providing well-led services.

Our key findings were as follows:

  • The practice had re-established a patient participation group (PPG). The group had met once and there were plans to meet in the near future but the date had yet to be confirmed.
  • The appraisal system had been embedded in the practice. Team leaders had received an appraisal and the programme had been rolled out across the practice. Staff told us that they had received an appraisal and we saw a record of appraisals to confirm this action.
  • Access to the practice telephone system continued to improve. Staff prioritised telephone answering and a dedicated team of staff answered the phones in a room separate from the main reception area.
  • Whilst feedback was still mixed on the availability of appointments we found that the practice could demonstrate that appointments could be obtained within reasonable timescales. We saw a number of appointments for GPs were released on a 48 hour basis. The information we saw confirmed that there were a number of appointments available for Monday 14 August for a salaried GP, practice nurses and a paramedic practitioner. Routine appointments for one of the partners were bookable but these had an average of a ten day wait.
  • The practice had appointed two paramedic practitioners and a nurse practitioner since our last inspection and we received feedback to confirm that these had been well received by patients.
  • The practice was now collating and reviewing their responses to the friends and family test. We spoke with the member of staff who had taken on this role and they told us that the results were reviewed and shared with the management and staff in the practice.


Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

16 February 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at Seaforth Farm Surgery on 2 November 2016. During this inspection we found breaches of legal requirement and the provider was rated as requires improvement under the safe, effective, responsive and well led domains.

As a result of that inspection we issued warning notices for breaches of regulations that had not been resolved since our comprehensive inspection in October 2015.

The practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:-

  • Ensuring all staff have undergone a risk assessment, and those with unsupervised access to patients, have undergone a check via the DBS. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable)
  • Ensuring all staff recruitment information required by regulation is in place and retained on file.
  • Ensuring that staff receive the training required to undertake their role and a system of appraisal is established and maintained.
  • Ensuring that they review the current telephone access arrangements and take the necessary steps to improve access for patients.
  • Ensure that a system is in place to monitor the quality of the services provided which includes collating and responding to patient feedback.

The full report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Seaforth Farm Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 16 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 2 November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

  • Staff had received enhanced DBS checks since our last inspection.
  • Recruitment records were in place as required by regulation including proof of identity, references and confirmation of the professional registration of clinical staff.
  • Training systems had been improved offering e-learning and face to face training for staff. Gaps in training found at the last inspection had been addressed.
  • An appraisal system had been re-established in the practice. Team leaders had received an appraisal however, the programme was yet to be rolled out across the practice.
  • Access to the practice telephone system had improved. Staff prioritised telephone answering and most patients we spoke with told us that access had improved.
  • The practice was now collating and reviewing their responses to the friends and family test.

At our previous inspection on 2 November 2016, we rated the practice as requires improvement for providing well-led services as there was no systems to take account of patients’ views. At this inspection we found that whilst some steps had been taken, the patient participation group or an alternative forum for patients had still not been introduced. Consequently, the practice is still rated as requires improvement for providing well-led services.

The areas where the provider must make improvements are:

  • The provider must ensure that a system is in place to monitor the quality of the services provided which includes establishing a system to take account of patients’ views.

Action the provider should take to improve:

  • The provider should continue to monitor the current telephone and appointment access arrangements and take the necessary steps to improve access for patients if required.

  • The provider should continue to monitor the implementation of the new appraisal system to ensure it is embedded and sustained in the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

2 November 2016

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 this practice on 15 October 2015. Breaches of Regulatory requirements were found during that inspection within the safe and effective domains. After the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the regulatory responsibilities in relation to the following:

  • Ensure the actions taken as a result of significant events are documented to demonstrate how information has been disseminated and reviewed.
  • Ensure all staff have satisfactory checks in place to ensure their suitability to carry out their role. This must include a check via the Disclosure and Barring Service (DBS) and proof of identity.
  • Ensure all staff receive training in safeguarding as according to job roles and new staff complete an induction to meet the needs of patients and the service.

In addition to these actions we had received concerns regarding access to appointments, patients unable to get through on the phone and the lack of systems to take account of the views of patents and other stakeholders.

We undertook this focused inspection on 2 November 2016 to check that the provider had followed their action plan and to confirm that they now met regulatory requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Seaforth Farm Surgery on our website at www.cqc.org.uk.

This report should be read in conjunction with the last report published in April 2016. Our key findings across the areas we inspected were as follows:-

  • We saw evidence that all significant events had been documented and discussed with staff. Meetings had been held to discuss and disseminate information, agree actions and monitor outcomes.
  • We found that not all staff had received a DBS check as required by regulation. Proof of identity was not evident for all staff and not all recruitment checks had been completed for staff employed since our last inspection.
  • We found that whilst a training plan was in place for most areas required by the practice safeguarding had not been undertaken by all staff. We also noted that not all staff had received infection control training.
  • There had been work undertaken to recruit new clinical and non-clinical staff to address concerns about appointments however this had not had time to make a significant impact on access to the practice.
  • The practice no longer had a functioning patient participation group and systems to monitor and take account of patient views had not been established.

Action the provider must take:

  • The provider must ensure that a system is in place to monitor the quality of the services provided which includes collating and responding to patient feedback.
  • The provider must ensure all staff have undergone a risk assessment and those with unsupervised access to patients have undergone a check via the DBS.
  • The provider must ensure all information required by regulation is in place and retained on file.
  • The provider must ensure that staff receive the training required to undertake their role and a system of appraisal is established and maintained.
  • The provider must ensure that they review the current telephone access arrangements and take the necessary steps to improve access for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

15 October 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Seaforth Farm Surgery on 15 October 2015. Overall the practice is rated as requires improvement.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. However work was needed to ensure the practice could demonstrate they learnt from these events.
  • Patients we spoke with and most comment card responses said they found it easy to make an appointment with GP. Six of twenty eight comment cards indicated there were difficulties with getting appointments. This was due to the telephone system. All feedback was positive in respect of the care and treatment received, 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 and complied with the requirements of the Duty of Candour.
  • The training of staff and checks carried out as part of recruitment did not always ensure patients were protected.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

  • Ensure the actions taken as a result of significant events are documented to demonstrate how information has been disseminated and reviewed.
  • Ensure all staff have satisfactory checks in place to ensure their suitability to carry out their role. This must include a check via the Disclosure and Barring Service and proof of identity.
  • Ensure all staff receive training in safeguarding as according to job roles and new staff complete an induction to meet the needs of patients and the service.

In addition the provider should:

  • Ensure patients are given information on what they can do if they are unhappy with the outcome of the practices investigation and response to their complaint.

  • Ensure the plans to improve the telephone system are completed.

  • Ensure a mechanism is in place to demonstrate how learning outcomes from audits are shared.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice