The Care Quality Commission
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  • GP practice

Archived: North Camp Surgery

Overall: Requires improvement read more about inspection ratings

2 Queens Road, Farnborough, Hampshire, GU14 6DH (01252) 517734

Provided and run by:
North Camp Surgery

All Inspections

15 September 2015

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an unannounced focussed, follow up inspection of North Camp Surgery, Queens Road, Farnborough, Hampshire GU14 6DH on 15 September 2015.

Our previous inspection in May 2015 had found the practice was requires improvement overall. Due to breaches of regulations relating to safe delivery of services and services being well-led. The practice was good for Effective, Caring and Responsive services.

From the inspection 15 September 2015 the practice is still rated as requires improvement overall. With requires improvement for the provision of safe and effective services. The practice is rated as inadequate for well-led services. The practice remains rated as good for the provision of caring and responsive services. In addition we had received information of concern from NHS England (national commissioning board and contract holder for GP practices) in relation to patients being placed at risk. These concerns referred to inconsistent patient record keeping and a high turnover of staff.

Key findings include:

  • The practice was not operating safe systems in relation to the recruitment of staff between May 2015-August 2015.
  • There was an inconsistent application of current clinical guidelines documented within patient records.
  • There was a lack of governance and management of the practice by those with the authority to make decisions.

However we found the practice had made improvements since our last inspection in May 2015. Specifically the practice was:

  • Monitoring hygiene and infection control, including a system of audit, identifying and assessing any risk of legionella.
  • Managing risk, assessments were in place and up to date for health and safety such as assessments relating to the premises and equipment.
  • Providing appropriate staff with chaperone training and the practice provided a chaperone service for patients in a timely way that does not delay any assessment or treatment needed.
  • Ensuring all new staff was performing their roles as needed and supported to have further development.
  • Ensuring the practice had arrangements to deal with emergencies with a revised and updated business continuity plan and an automated external defibrillator (AED) in place.
  • Securely handling blank prescription forms consistently in accordance with national guidance.

There were areas of practice where the provider needs to make improvements. Importantly, the provider must:

  • Ensure all patient records are accurate and up to date.
  • Ensure recruitment arrangements include all necessary employment checks for all staff.
  • Ensure there is clear leadership structure, sufficient leadership capacity and formal governance arrangements.

Where a practice is rated as inadequate for one of the five key questions or one of the six population groups it will be re-inspected within six months after the report is published. If after re-inspection it has failed to make sufficient improvement and is still rated as inadequate for any key questions or population group we will place into special measures. Being placed into special measures represents a decision by CQC that a practice has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

11 May 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of North Camp Surgery, 2 Queens Road, Farnborough, Hampshire, GU14 6DH on 11 May 2015. Overall this practice is rated as requires improvement. This practice was inspected at this time following concerns raised by NHS England. The practice had been required by NHS England to not carry out any immunisations until the outcome of an investigation.

Specifically, we found the practice to be good for providing, effective, caring and responsive services. It also required improvement for providing services to older people, people with long term conditions, families, children and young people, working age people, people whose circumstances may make them vulnerable and people experiencing poor mental health. It required improvement for providing safe services and well led.

•               Patients were complimentary about the care and support they received from staff. The practice had responded to the needs of an increasing Nepalese population group by employing a Nepalese speaking receptionist. Two of the GPs could also speak Nepalese.

•               Staff told us they were committed to providing a service that put patients first.

•               The practice worked with other health and social care professionals and organisations to ensure that their patients received the most effective support and treatment. However at the time of our inspection the practice had been required to stop immunisation of patients by NHS England.

•               Staff were trained in and aware of their responsibilities for safeguarding of vulnerable adults and children. There were systems and processes in place to raise concerns and there was a culture of reporting and learning from incidents within the practice.

•               Patients told us they could always get an emergency appointment and waiting time for routine appointments was satisfactory.

•               The GP partners and salaried GP said they were committed to working to keep a high level of patient service as well as dealing with the challenges of putting a new team together and the embedding of training and knowledge.

The areas where the provider must make improvements are:

     ·         Have risk assessments in place and up to date for health and safety such as for the premises and equipment.

     ·        The practice must have policies and risk assessments in place such as for detecting and controlling the spread of infections.

     ·        The practice must ensure the recruitment policy is up to date and is followed including for temporary staff.

     ·        The practice must be able to provide a chaperone service for patients in a timely way that does not delay any assessment or treatment needed. 

      ·        The practice must have an overall governance arrangement to ensure that all new staff are performing their roles as needed and supported to have further development.

The provider should:

  • Have an automated external defibrillator (AED) in place.
  • Handle blank prescription forms consistently in accordance with national guidance, whilst they were locked away the access to the keys was not restricted at all times and they were not tracked through the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

8 May 2014

During an inspection looking at part of the service

At our last inspection in December 2013 we found that people who use the service were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We judged this concern to have a minor impact on people who used the service.

The provider was required to submit a plan detailing the action they would take to ensure compliance with this standard and the date at which they would be compliant. The provider told us in their plan that they would be compliant with this standard by 30 April 2014.

At this inspection we reviewed the progress the provider had made and found that they had taken sufficient action to address the area of concern.

The service had a safeguarding children's policy and were developing a safeguarding adult's policy following training on 22 April 2014. This included details of what staff should do if they had safeguarding concerns and who they should report concerns to. This meant that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

17 December 2013

During a routine inspection

We spoke with seven adult patients and one child on the day of the inspection visit. We also spoke with all three GPs, the practice manager, practice nurse, three administration staff and two external community health care professionals.

Patients told us that they felt well informed and involved in making decisions about their care and treatment. They said that all staff were approachable. Confidentiality was protected. Patients were happy with the care and treatment they received and valued the local services provided.

We looked at the processes that the practice had in place to ensure the patients were protected from abuse. We found that not all staff had received appropriate training on all safeguarding issues.

Whilst there was no formal training programme in place for everyone, staff told us that they had training and development opportunities and that they were well supported by the provider. They felt qualified for their roles and responsibilities.

We found processes in place to review and monitor the quality of the service provided. There was learning from the processes and the information was used to improve the service.

Not all the services provided by the practice had been registered under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009. However, we saw at the visit that relevant applications were underway and would be submitted to the Care Quality Commission as soon as possible. This would be monitored until the processes were completed.