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