Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hillsprings Health and Wellbeing Centre (known as Hillsprings Surgery) on 22 March 2016. The overall rating for the practice was Requires Improvement. We found two breaches of legal requirements and as a result we issued a warning notice in relation to:

• Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 – Safe Care and Treatment

We also issued a requirement notice in relation to:

• Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 – Good Governance

We undertook an announced focused inspection on 31 August 2016 to follow up on the warning notices. We found that the provider met legal requirements in relation to Regulation 12.

Both the full comprehensive report on the March 2016 and the focused inspection on 31 August 2016 can be found by selecting the ‘all reports’ link for Hillsprings Health and Wellbeing Centre on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection on 6 April 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they had been offered an appointment on the day they contacted the practice. Urgent appointments and pre-bookable appointments were also available.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, there were areas practice where the provider should make improvements:

• Ensure that patient records demonstrate that high risk medicines are being prescribed safely.
• Formalise and record clinical supervision which takes place between the nurse practitioner and GP.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hillsprings Health and Wellbeing Centre on 22 March 2016. A breach of legal requirement was found and a warning notice was served. The practice sent us an action plan to say what they would do to meet legal requirements in relation to:

• Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Safe care and treatment.

We undertook a focused inspection on 31 August 2016. We visited Hillsprings Health and Wellbeing Centre to check that the practice had followed their action plan and to confirm they now met legal requirements in relation to Regulation 12. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Hillsprings Health and Wellbeing Centre on our website at www.cqc.org.uk.

Our key findings were as follows:

• The practice had reviewed, updated or developed policies and discussed these with staff at practice meetings.
• The practice had introduced a system to act upon medicines and equipment alerts issued by external agencies. Alerts were reviewed and appropriate action taken.
• The practice had introduced an effective system to ensure the safe and proper management of patients prescribed high risk medicines. Patients prescribed these medicines were monitored in line with recommended guidance.
• Vaccines were being stored in line with manufacturers’ guidance.
• Infection control audits had been carried out at each site and action taken to address any identified issues.
• All clinical equipment had been serviced / calibrated and reminders introduced to ensure these checks were carried out annually.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hillsprings Health and Wellbeing Centre (known as Hillsprings Surgery) on 22 March 2016. The overall rating for the practice was Requires Improvement. We found two breaches of legal requirements and as a result we issued a warning notice in relation to:

• Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 – Safe Care and Treatment

We also issued a requirement notice in relation to:

• Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 – Good Governance

We undertook an announced focused inspection on 31 August 2016 to follow up on the warning notices. We found that the provider met legal requirements in relation to Regulation 12.

Both the full comprehensive report on the March 2016 and the focused inspection on 31 August 2016 can be found by selecting the ‘all reports’ link for Hillsprings Health and Wellbeing Centre on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection on 6 April 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they had been offered an appointment on the day they contacted the practice. Urgent appointments and pre-bookable appointments were also available.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, there were areas practice where the provider should make improvements:

• Ensure that patient records demonstrate that high risk medicines are being prescribed safely.
• Formalise and record clinical supervision which takes place between the nurse practitioner and GP.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

On the day of our inspection we spoke with eight patients and six members of staff. Prior to the inspection we spoke with a spokesperson from the patient participation group (PPG) who was also a patient. PPGs are an effective way for patients and GP practices to work together to improve the service and to promote and improve the quality of the care. One patient told us, “If I was in trouble, I would feel confident of getting the help I needed from here”. Another patient told us, “The quality of care is brilliant here. It is really good”.

We saw that patient’s views and experiences were taken into account in the way the service was provided and that patients were treated with dignity and respect. We saw that patients experienced care, treatment and support that met their needs. They were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening.

The provider had its own dispensary for patients who lived over one mile away from their nearest pharmacy. We saw that patients were not protected against the risks associated with medicines because the provider did not have effective systems in place to ensure that medicines were in date. We saw that there was no system in place to record when medicines came into or went out of the dispensary.

We saw that there were effective recruitment and selection processes in place. This meant that patients were cared for by suitably qualified, skilled and experienced staff.

The provider had an effective system to regularly assess and monitor the quality of the service that patients received.