HMC Health Hounslow

We carried out an announced comprehensive inspection at HMC Hounslow on 05/03/2019. The overall rating for the practice was Requires Improvement. The full comprehensive report on the inspection can be found by selecting the ‘all reports’ link for HMC Hounslow on our website at www.cqc.org.uk.

This inspection, on 15/10/2019, was an announced comprehensive inspection to confirm that the practice had carried out their plan to meet the requirements that we identified in our previous inspection on HMC Health Hounslow. This report covers our findings in relation to those requirements and any improvements made since our last inspection. The practice is now rated as Good overall.

This inspection focused on the following key questions:

Are services safe?

Are services effective?

Are services caring?

Are services responsive?

Are services well led?

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 and good for all population groups.

We found that:

• The service had made changes to ensure care and treatment was provided in a safe way to patients.
• The service had established effective systems and processes to ensure good governance in accordance with the fundamental standards of care in response to our previous inspection.
• The service had ensured specified information was available regarding each person employed.
• The service had appropriate standards of cleanliness and hygiene.
• The service had adequate systems to assess, monitor and manage risks to patient safety.
• The service organised and delivered services to meet patients’ needs.
• The service listened to complaints and used them to improve the quality of care.
• The service involved the public, staff and external partners to sustain care standards. This included an active patient participation group.

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

• Continue to monitor patient feedback in relation to telephone access issues being experienced.
• Continue to improve the identification of carers to enable this group of patients to access the care and support they need.
• Improve uptake of cervical screening at the practice.
• Consider sepsis awareness refresher training for non-clinical staff.
• Follow up failsafe processes for some high-risk medicines.
• Ensure recruitment documents are up-to-date for all staff.
• Consider additional internal thermometers for vaccine fridges in line with current guidance.

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

We carried out an announced comprehensive at HMC Health Hounslow on 5 March 2019. We carried out this inspection in response to concerns that one or more of the essential standards of quality and safety were not being met.

The practice is rated as requires improvement overall.

We based our judgement of the quality of care at this service is 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 rated the practice as requires improvement for providing safe services because:

• Improvements were needed to mitigate the risks relating to equipment, infection control and health and safety.

We rated the practice as requires improvement for providing well-led services because:

• The new provider faced unprecedented challenges once they took over the practice in October 2018. As a result, we found gaps in monitoring some administrative activities and maintaining recruitment and training records for some staff employed by the previous provider.

We rated the practice as good for providing effective, caring and responsive services because:

• The practice had some systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect. Feedback from patients we spoke with and CQC comment cards stated staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it. The practice had increased staffing levels and opening hours to improve access to the service.
• The practice was under new management since October 2018. Leaders had a realistic strategy to achieve most key priorities.

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 specified information is available regarding each person employed.

The areas where the provider should make improvements are:

• Take action to improve the induction process for locum staff.
• Implement reviews of prescribing practice for non-medical prescribers.
• Improve the process of ongoing monitoring of safety alerts.
• Improve the identification of carers to enable this group of patients to access the care and support they need.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care