The Care Quality Commission
  • Doctor
  • GP practice

Archived: The Heaton Medical Practice

Overall: Inadequate read more about inspection ratings

Haworth Road Health Centre, Haworth Road, Bradford, West Yorkshire, BD9 6LL (01274) 541701

Provided and run by:
The Heaton Medical Practice

All Inspections

11 September 2018

During a routine inspection

We carried out an announced comprehensive inspection at The Heaton Medical Practice name on 11 September 2018, as part of our inspection programme.

At this inspection we found:

  • Staff were not sufficiently trained in safeguarding awareness relevant to their role.
  • The provider had not acted on issues identified during a recent infection prevention and control audit or ensured that all staff were trained in infection prevention and control.
  • The provider did not consistently ensure that a GP was onsite, and Advanced Nurse Practitioners were routinely seeing acutely ill children under the ages of two years, without having received enhanced training to undertake this role.
  • Newly appointed staff did not have a programme of planned training as part of their induction or documented updates on their progress. The practice provided staff with limited ongoing support.
  • During the inspection, we identified 210 outstanding test results on the system, 62 of these dated back to January 2018.
  • Temperature sensitive medicines were not transported to patients’ home in an approved medical grade cool box.
  • Prescription stationery was not monitored by the provider for audit and security purposes.
  • There was an absence of risk assessment activity, including both fire and Health and Safety.
  • The provider’s management of significant events and learning from them was insufficient.
  • The practice could not consistently ensure that End of Life care was delivered in a coordinated way because there were insufficient GPs available to visit patients in need.
  • There was not an effective system in place for following up patients with a mental illness who failed to attend for their appointments.
  • The practice did not have a full understanding of the learning needs of staff and did not consistently provide protected time and training to meet them. We received mixed views from staff we interviewed; some staff felt well-supported whilst others told us they felt left to cope in a high-pressure environment.
  • Members of the leadership team, which comprised the Registered Manager, second GP partner and the Business Manager did not visit the site on a regular basis or maintain effective oversight of activities at the location.
  • The leadership team did not arrange or attend meetings with either the clinical or non-clinical team. We saw that the practice had not had a staff meeting since March 2018.
  • A range of policies we reviewed contained out of date information. Staff were not sufficiently trained or aware of their role in notifying external organisations of significant events.
  • The provider had not shared the findings of the survey with the staff team or drafted an action plan to address the issues raised.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure there is an effective system for identifying, receiving, recording, handling and responding to complaints by patients and other persons in relation to the carrying on of the regulated activity.

The areas where the provider should make improvements are:

  • Improve the provision of independent interpretation services for patients who need this service to be assured of their privacy, dignity and safety.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

We are taking further action in line with our enforcement processes. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

1 November 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Heaton Medical Practice on 1 November 2016. Overall the practice is rated as good, for providing safe, caring, effective and well-led care for all of the population groups it serves. We have rated the practice as requiring improvement for providing responsive services.

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. We saw that development and learning was prioritised by the practice and 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 during consultations with their GP.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients we spoke with on the day said it was easy to make an appointment with their preferred GP.
  • 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. Staff told us that they would feel confident to raise any concerns with the lead GP or practice manager.
  • The practice sought feedback from patients and the Patient Participation Group (PPG), which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement

  • The practice should continue to review their National GP Patient Survey results with the aim of understanding their patient’s concerns and improving their experiences when using the service in the future.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

13 May 2014

During an inspection looking at part of the service

Our inspection on 5 November 2013 found the practice did not have robust systems in place which were designed to assess the risk of and prevent and control the spread of health care associated infections. Plus we found the provider was not carrying out appropriate recruitment checks.

Following the inspection the provider wrote to us and told us they would take action to ensure they were compliant with these essential standards.

At this inspection we found that improvements had been made. The provider had reviewed their policies and procedures and implemented new systems which assessed the risk of and prevented the spread of health care associated infections. In addition they had reviewed the recruitment procedure to make sure it informed staff of the actions they must take to ensure only suitable staff were employed at the practice.

5 November 2013

During a routine inspection

We spoke with two people who were representatives of the patient participation group (PPG). They told us when issues had been raised the practice had responded. Previously people had difficulty in making appointments by telephone and making appointments with the same doctor because there had been a shortage of medical staff. The practice had responded by recruiting six new doctors and installing a new telephone system. They told us the practice was 'improving'. We found people were provided with the opportunity to make complaints and any complaints had been responded to.

People who used the service were protected against the risk of abuse. Staff had received training in abuse awareness and protecting children and vulnerable adults. Policies and procedures were available to all staff in relation to safeguarding.

We looked at the premises and found the practice did not have robust systems in place which were designed to assess the risk of and prevent and control the spread of health care associated infections.

We also found people were put at risk because the practice was not following their recruitment process and had not carried out all the appropriate checks before staff had started work.

The provider explained some of the doctors had left or retired from the practice but they had not registered this with the CQC. We explained to the provider and the practice manager that under the Health and Social Care Act 2008, providers must, by law, register with CQC if they carry out a regulated activity. It was the provider's responsibility to make sure they are appropriately registered to carry on the activities they provided. The provider agreed to immediately submit an application to register the service correctly.