The Care Quality Commission
  • Doctor
  • GP practice

The Boulevard Medical Practice

Overall: Good read more about inspection ratings

116 Savile Park Road, Halifax, HX1 2ES (01422) 365533

Provided and run by:
Boulevard Medical Practice Ltd

Important: The provider of this service changed - see old profile

All Inspections

21 and 22 June 2023

During a routine inspection

We carried out an announced comprehensive inspection at The Boulevard Medical Practice on 21 and 22 June 2023. Overall, the practice is rated as good.

Safe - good

Effective - good

Caring - good

Responsive - good

Well-led - good

Following our previous inspection in May 2022, the practice was rated requires improvement overall and for providing effective, responsive and well-led services. We rated the provider inadequate for providing safe services and good for providing a caring service. As a result of this inspection, we issued a warning notice in respect of Regulation 12 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Safe care and treatment and a requirement notice in respect of Regulation 17 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Good governance.

We then carried out a focused unrated inspection inspection in October 2022. The purpose of this inspection was to review actions taken by the provider in response to a warning notice in respect of Regulation 12 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Safe care and treatment. At this inspection we found the provider had taken steps to become compliant with Regulation 12.

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

Why we carried out this inspection

We carried out this comprehensive inspection to follow up breaches of regulation from the previous inspection in May 2022 in line with our inspection priorities.

How we carried out the inspection

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.
  • A short site visit.
  • Staff questionnaires.

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 taken steps to address the breaches of regulation identified at the previous inspection. For example, we saw that patients with a long-term condition were being managed appropriately, there was a system in place for the review and management of patient safety alerts and NICE guidance and an updated electronic system to ensure staff appraisals were carried out annually.
  • The practice was committed to continually monitoring and improving the service and could demonstrate this through audit activity and changes made to the service as a result of findings.
  • 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.
  • Patients could access care and treatment in a timely way. The practice continually monitored access and GP partners at the practice worked flexibility to increase access for patients.
  • The practice GP partners and the management team were committed to the safety and well-being of staff. We heard of numerous incentives for staff including access to counselling and support.
  • 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:

  • Consolidate the in-house safeguarding register with patients identified by clinical systems search.
  • Review smartcard access rights to allocate correct level of access to all clinical and non-clinical staff members.
  • Improve pre-employment health assessment to capture immunisation status and take appropriate steps to comply with requirements laid out in chapter 12 of the Green Book.
  • Continue to progress patient notes summarising.

27 October 2022

During an inspection looking at part of the service

Why we carried out this inspection

We previously carried out an announced comprehensive inspection at The Boulevard Medical Practice on 24 and 25 May 2022. The overall rating for the practice was requires improvement. The provider was rated inadequate for providing safe services and was told they must improve. We issued a warning notice in respect of Regulation 12 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Safe care and treatment.

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

This inspection was an announced focused unrated inspection, carried out on 27 October 2022. The purpose of the inspection was to review actions taken by the provider in response to the warning notice.

How we carried out the review

This inspection was carried out remotely and included:

  • 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.
  • Conducting a feedback and discussion session with practice representatives using video conferencing.

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 taken steps to become compliant with Regulation 12 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
  • The practice had an updated protocol in place for the management of safety alerts. The practice was running clinical searches on a monthly basis to identify patients affected by historical safety alerts.
  • The practice had a process in place for checking the monitoring of disease modifying anti-rheumatic drugs (DMARDs) and high risk drugs with recalls and reminders being used to ensure patients have received the required monitoring checks.
  • Patients with a long-term condition were being managed appropriately.
  • Improvements in the practice processes for identifying and coding patients with diabetes and chronic kidney disease had been made.

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

  • Review process for management of safety alerts to include appropriate searches of clinical records and ensure that staff refer to safety alert guidance when prescribing new medication mentioned in alerts.

Take action to review the 8 patients potentially co-prescribed Clopidogrel and Omeprazole/Esomeprazole.

24 & 25 May 2022

During a routine inspection

We carried out an announced inspection at The Boulevard Medical Practice on 24 & 25 May 2022. Overall, the practice is rated as Requires Improvement.

Safe - Inadequate

Effective – Requires Improvement

Caring - Good

Responsive - Requires Improvement

Well-led – Requires Improvement

Following our previous inspection on 21 August 2019, the practice was rated Good overall.

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

Why we carried out this inspection:

This inspection was a comprehensive inspection. It included a site visit of the main site and branch site. We reviewed all five key questions during the course of the inspection. In addition, we reviewed areas identified for improvement at our previous inspection.

How we carried out the inspection.

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
  • Reviewing staff question sheets sent prior to the inspection for staff at all levels to complete and submit in confidence.

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 Requires Improvement overall

We found that:

  • Systems for clinical oversight of chronic conditions and medicines reviews were not sufficiently thorough.
  • Diagnostic coding on patients’ records were not always in place.
  • There was evidence of mainly one-cycle audit activity/patient searches, with plans to implement improvements.
  • Patients were able to access face to face or telephone appointments at either of the two sites provided by the practice.
  • Priority was given to patients under the age of five years and those approaching end of life for same day appointments.
  • Staff told us they were happy to work at the practice. They told us the senior team was supportive.
  • Staff demonstrated a caring and respectful approach when discussing patients’ needs.
  • We saw feedback from patients which was positive about the care they received.

We found breaches of regulations. The provider must:

  • 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.

In addition, the provider should:

  • Improve safeguarding practices to ensure that safeguarding alerts are added to records of all family members where there are safeguarding concerns.
  • Standardise meeting structures to promote full staff involvement and optimise information sharing and updating.
  • Complete appraisals for all staff in a timely manner to promote staff development and performance management.
  • Develop systems to improve the engagement of the patient participation group, and continue to monitor patient satisfaction with services.
  • Continue to utilise resources within the staff team and external support to improve uptake of cervical screening.

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