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Hartshill Medical Centre Good


Review carried out on 14 September 2019

During an annual regulatory review

We reviewed the information available to us about Hartshill Medical Centre on 14 September 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 28 November 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. We previously inspected this practice on 24 November 2014 and rated it Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive at Hartshill Medical Centre on 28 November 2017 as part of our inspection programme.

At this inspection we found:

  • The practice had clear 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. However, a risk assessment to reflect guidance from The Control of Substances Hazardous to Health Regulations 2002 (COSHH) in relation to the storage or spillage of mercury had not been completed.

  • The practice had clear systems to keep patients safe and safeguarded from the risk of abuse.

  • The practice had developed effective ways of reducing patient A&E attendance. All patients that attended A&E were reviewed at a weekly clinical meeting.

  • 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.

  • The practice had signed up to the local authority’s safer places scheme to work as part of a network of organisations to provide assistance and support to vulnerable people over 14 years if they felt anxious or scared whilst out in the community.

  • The practice had responded to the issues patients experienced when trying to access appointments by recruiting an additional GP partner and planned to purchase a new telephone system.

  • There was a strong focus on continuous learning and improvement at all levels of the organisation. Two of the GP partners were educational tutors at the local university. We saw that the knowledge and experiences they gained from these roles were embedded in the practice’s culture of continuous improvement.

There was one area of outstanding practice:

  • The practice provided two hours a week of dedicated appointments for the A&E department to redirect patients to the practice if they attended A&E inappropriately. Data for 2015/16 and 2016/17 showed a fall from 14.7% to 11.9% of inappropriate A&E attendances for patients registered with the practice.

The areas where the provider should make improvements are:

  • Update their recruitment policy to include reference to accounting for gaps in employment history and checking that professional registrations for clinical staff are in date.

  • Complete a risk assessment to reflect guidance from The Control of Substances Hazardous to Health Regulations 2002 (COSHH) in relation to the storage or spillage of mercury.

  • Continue to seek out ways to improve the identification of carers registered with the practice.

  • Review the Care Quality Commission (Registration) Regulations 2009 to support their understanding of incidents that are notifiable to the Care Quality Commission.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 24 November 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We inspected this service on 24 November 2014 as part of our new comprehensive inspection programme.

The overall rating for this practice is good. We found the practice to be good in all five of the domains. We found the practice provided good care to older people, people with long term conditions, people whose circumstances may make them vulnerable, families, children and young people, working age people and people experiencing poor mental health.

Our key findings were as follows:

  • Patients were kept safe because there were arrangements in place for staff to report and learn from key safety risks. The practice had a system in place for reporting, recording and monitoring significant events over time.
  • There were systems in place to keep patients safe from the risk and spread of infection. Systems were in place to monitor and make required improvements to the practice when required.
  • Patients were satisfied with how they were treated and this was with compassion, dignity and respect. GPs were good at listening to patients and gave them enough time.
  • Most patients told us they were satisfied with the appointments system and that it met their needs.

We saw several areas of outstanding practice including:

  • The practice recognised the importance of maintaining a carer’s health to enable them to continue to provide care and support to the people they provided care for. To do this, carers were offered additional health checks and the ‘flu vaccination.

  • The practice kept daily open appointments so if one of their patients inappropriately attended the neighbouring A&E department, they could be re-directed back to the practice to ensure they received the most appropriate care and treatment.

  • The practice ran an annual health promotion event aimed mainly at patients from black minority groups who were at a higher risk of diabetes and cardiovascular disease. These were held in the evening to allow working age patients to access them. The practice had identified several patients with undiagnosed diabetes as a result of the events.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

  • Provide staff with training in safeguarding vulnerable adults at a level appropriate to their role.

  • Carry out safeguarding checks to ensure that receptionists who carry out chaperoning duties are suitable to work in this capacity.

  • Develop a long term business plan that encompasses a risk management structure to ensure systems that are in place will be maintained when experienced staff leave and take their knowledge and experience with them.

  • Complete clinical audit cycles to monitor that changes made to patients’ care and treatment have made improvements to their health outcomes.

  • Introduce a systematic way of reviewing and evaluating which NICE guidelines are appropriate to meet their patients’ needs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice