This practice is rated as Good overall. (Previous rating November 2017 – Requires improvement)

We carried out an announced comprehensive inspection at Horden Group Practice 23 November 2017. The overall rating for the practice was requires improvement with requires improvement for the domains of safe and well-led and good for effective, caring and responsive.

We carried out an announced comprehensive inspection at the practice on 30 August 2018 to confirm that the practice had carried out their plans to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in November 2017. This report covers our findings in relation to those requirements.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

The report on the November 2017 inspection can be found by selecting the ‘all reports’ link for Horden Group Practice on our website at .

At this inspection we found:

• The practice had systems to keep patients safe and safeguarded from abuse.
• 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.
• The practice routinely reviewed the effectiveness and appropriateness of the care they provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
• The practice scored higher than the local clinical commissioning group (CCG) average in every question in the National GP Patient Survey.
• Feedback from patients was consistently and strongly positive.
• The practice organised and delivered services to meet patients’ needs. They took account of patient needs and preferences.
• Access to appointments at the practice was good. Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
• There was a focus on continuous learning and improvement at all levels of the organisation. The practice proactively used performance information to drive improvement.

The areas where the provider should make improvements are:

• Review the process for the repeat prescribing and monitoring of high risk medicines.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

This practice is rated as requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

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 – Requires improvement

People with long-term conditions – Requires improvement

Families, children and young people – Requires improvement

Working age people (including those recently retired and students – Requires improvement

People whose circumstances may make them vulnerable – Requires improvement

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

The population groups are rated requires improvement overall because t

here are aspects of the practice that require improvement which therefore has an impact on all population groups. There were, however, examples of good practice.

We carried out an announced comprehensive inspection at Horden Group Practice on 23 November 2017.

We inspected this service as part of our comprehensive inspection programme.

At this inspection we found:

• Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses.

• Outcomes for patients who use services were good.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion.

• Information was provided to patients to help them understand the care and treatment available.

• 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.

• There was a clear leadership structure in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.

• The practice was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• ​

  The practice provided a teledermatology service to all local patients. The practice could pho

  tograph skin lesions and send the images securely to a Consultant Dermatologist to diagnose whether further treatment was necessary or not.This r

  educed unnecessary hospital referrals and was a

  convenient and quick service for patients. There had been 103 teledermatology referrals over the last year.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure there is an effective system for infection control. (See Requirement Notice Section at the end of this report for further detail).

• Ensure the proper and safe management of medicines.

• Ensure a system is in place for the management of patient safety alerts.

• Ensure health and safety risk assessments are carried out.

The areas where the provider should make improvements are:

• Carry out a risk assessment for non-clinical staff who have not received a disclosure and barring check (DBS).

• Develop a system the practice can monitor and ensure all equipment at the practice is fit for purpose.

• Assure themselves that patients know how they can complain about services from the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice