We carried out an announced comprehensive inspection at Drs P Keating & H Appleton on 21 November 2019 as part of our inspection programme. At this inspection we followed up on breaches of regulations identified at a previous inspection on 31 August 2017.
The practice was first inspected in January 2017. We rated the practice inadequate for providing safe and effective services, requires improvement for providing caring and well-led services and good for providing responsive services. We rated the population groups, People with long term conditions and People experiencing poor mental health as inadequate. We rated the population groups Older people, Families, children and young people and Working age people as requires improvement. Breaches of legal requirements were found in relation to services being safe and effective in the practice. We issued the practice with warning notices for regulation 12, safe care and treatment and for regulation 18, staffing. The warning notices required the practice to achieve compliance with the regulations by 28 April 2017. We issued the practice with a requirement notice for a breach of regulation 17, good governance. Following the inspection, the practice was placed in special measures for a period of six months.
We conducted a focused inspection in May 2017 to identify whether the practice had addressed the issues in the warning notices. At the focused inspection on 31 May 2017 we found that the requirements of the warning notice had been met.
We undertook a follow-up comprehensive inspection in August 2017 following a period of special measures. We found action had been taken to address issues identified in the January 2017 inspection although there were areas where further improvements were required. We issued the practice a requirement notice for a breach of regulation 12, safe care and treatment. We rated the practice requires improvement overall and for providing safe and well-led services and for all population groups. We rated the practice good for providing effective, caring and responsive services.
The full comprehensive report on the January 2017, May 2017 and August 2017 inspections can be found by selecting the ‘reports’ link on our website at www.cqc.org.uk/location/1-594846881.
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.
At this inspection we have rated this practice as good overall and good for all population groups.
We found that:
- The practice had taken action to ensure care was provided 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 organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
Whilst we found no breaches of regulations, the provider should:
- Consider putting a process in place to monitor how performance data is entered on the computer system with a view to ensuring information is entered in a timely manner and is accurate.
- Continue to monitor uptake rates for public health screening programmes with a view to bringing about further improvements.
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