Horizon Health Centre Also known as (within) For All Healthy Living Centre

Updated 19 December 2023

Horizon Health Centre is located in Weston-Super-Mare at:

68 Lonsdale Avenue

Weston-Super-Mare

Somerset

BS23 3SJ

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.

Horizon Health Centre is based in the For All Healthy Living Centre on a large housing estate. The provider does not own the premises which are shared with a range of other social and health services, facilities and activities offered for the local community. These include a community cafe, lunch club, community hall, library, children's centre, church, meeting, training and office spaces. There are good transport links nearby.

The practice is one of 2 registered locations under the provider Pier Health Group Ltd. The practice is part of Bristol, North Somerset and South Gloucestershire (BNSSG) Integrated Care Board (ICB) and the Pier Health Group primary care network (PCN).

The practice provides NHS services through an Alternative Provider Medical Services (APMS) contract to approximately 5,660 patients. This is part of a contract held with NHS England. The practice offers services from both a main practice and a sister site, Graham Road Surgery.

Patients are registered at one main location and if needed can access services at either surgery.

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the lowest decile (1 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 95% White, 2% Asian, and 2% Mixed.

The practice’s clinical team is overseen by a lead GP and includes 2 GPs, advanced nurse practitioners, practice nurses and a prescribing paramedic. A team of administration staff supports the clinical team. The practice manager shares their time with Horizon Health Centre and a sister site, Graham Road Surgery.

The practice is open between 8 am to 6:30 pm Monday to Friday and one Saturday a month between 8.30 am and 1.00 pm. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

The practice has opted out of providing an out-of-hours service. Patients calling the practice when it is closed are referred to the local out-of-hours service provider via NHS 111.

Updated 19 December 2023

We carried out a short notice announced comprehensive inspection at Horizon Health Centre on 25 May 2023. Overall, the practice is rated as Inadequate.

The key questions are rated:

Safe - inadequate

Effective - requires improvement

Caring - requires improvement

Responsive - requires improvement

Well-led - inadequate

Following our previous inspection on 4 July 2022, the practice was rated as requires improvement overall and for providing safe, effective and well led services. They were previously rated as good for providing caring and responsive services.

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

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from a previous inspection in line with our inspection priorities.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.

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 found that:

• The practice had not implemented necessary improvements to address breaches in regulations previously identified.
• The practice was unable to demonstrate that individual care records were managed appropriately; and that staff had access to relevant information to ensure safe care and treatment.
• The practice had not ensured medicines were appropriately authorised before being administered by staff.
• Positive outcomes from GP national patient surveys remained below national averages.
• There were no appropriate arrangements to manage backlogs of activity.
• Oversight was not effective to ensure processes were embedded and operated effectively.

At this inspection we found that not enough improvements had been made to address previous breaches in regulation identified during our last inspection in July 2022 and additional areas of risk were also identified. We served warning notices to the provider for breaches of Regulation 17 Good governance.

The areas where the provider must make improvements:

• 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.

The areas where the provider should make improvements:

• Continue to identify and take action to improve uptake of childhood immunisations and cervical screening.
• Take action to improve the patient experience and address areas of concern identified in national GP patient surveys.

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 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.

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 vary the provider’s registration 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.

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 Health Care