• Doctor
  • GP practice

Hesa Medical Centre

Overall: Good read more about inspection ratings

52 Station Road, Hayes, Middlesex, UB3 4DS (01895) 320910

Provided and run by:
Sunrise Medical Centre

Important: The provider of this service changed. See old profile

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Hesa Medical Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Hesa Medical Centre, you can give feedback on this service.

23 September 2021

During an inspection looking at part of the service

We carried out an announced inspection at Hesa Medical Centre on 23 September 2021. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 27 January 2021 the practice was rated Requires Improvement overall and for the Safe, Effective and Well-led key questions and Good for being Caring and Responsive.

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

Why we carried out this inspection

This was a focused inspection to follow up on:

  • The Safe, Effective and Well-led key questions.
  • The breach of regulation 17HSCA 2014 (good governance) and the areas where we previously said the practice should review and improve.
  • This inspection did not include a review of the Caring and Responsive key questions. The rating of Good for those key questions was carried forward from the previous inspection.

How we carried out the inspection/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 inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

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 short site visit.
  • Sending surveys to staff to complete and return by email.

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 have rated this practice as Good overall

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm. Previous concerns around staff recruitment, supervision of clinical staff, the management of patients on high risk medicines and patient safety alerts had been addressed.
  • Patients received effective care and treatment that met their needs. Previous concerns around the management of diabetic patients had been addressed and positive steps had been taken to improve performance around childhood immunisation and cervical cancer screening rates.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care. Previous concerns around the monitoring of the practices safety and governance processes had been addressed.

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

  • Review and improve the provision of time during work hours for staff to undertake mandatory training required for their role.
  • Review and improve opportunities for staff to develop their careers.

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

27 January to 27 January 2020

During a routine inspection

We carried out an announced comprehensive inspection at Hesa Medical Centre as part of our inspection programme. This is the first inspection of this service that has taken place.

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 have rated this practice as Requires Improvement overall.

We rated them requires improvement for safe, effective and well-led and good for caring and responsive. We rated them good for population groups older people, people whose circumstances make them vulnerable and mental health. We rated them require improvement for families and children, people with long term conditions and mental health.

The practice is rated requires improvement for Safe as not all staff files contained copies of references, there was no evidence of regular clinical supervision or peer review for all clinical staff. We also found the practice did not have a consistent process for monitoring patients on high risk medication. Further, there was no process for ensuring patient safety alerts were actioned appropriately.

The practice is rated requires improvement for Effective due to the childhood immunisations, cervical screening rates and the management of their diabetic patients being below national targets.

The practice is rated requires improvement for Well-led as the provider did not operate effective monitoring of their safety and governance processes to ensure they were always followed by all staff.

We Found:

•The practice did not always provide care in a way that kept patients safe and protected them from avoidable harm.

•The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

•They offered home visits and urgent appointments for those with enhanced needs and complex medical issues.

•Staff demonstrated commitment and engagement with the vision for the service. They were proud to work for the organisation.

•Staff performance was not always monitored and reviewed

•The practice promoted good health and prevention and provided patients with suitable advice and guidance.

•There was a commitment to work with external partners

•The service had a business development strategy and quality improvement plan.

The areas where the provider must make improvements are:

•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 are:

•Continue to implement processes to improve the take up of childhood immunisations.

•Continue to implement processes to improve the take up of cervical smears.

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