We carried out an announced comprehensive inspection at Horton Park Medical Practice on 22nd and 25th May 2018. The overall rating for the practice was good, however we rated the provision of safe services as ‘requires improvement’. The full comprehensive report for the May 2018 can be found by selecting the ‘all reports’ link for Horton Park Medical Practice on our website.

This inspection was an announced focused inspection carried out on 28 March 2019 to confirm that the practice had made the required improvements in providing safe services.

Our key findings were as follows:

• The provider had undertaken a fire risk assessment and acted on any requirements. A fire drill had been undertaken at both sites and the provider was assured that staff were aware of and able to follow the fire procedure.
• An assessment regarding the risk of legionella had been renewed and the findings acted upon. We saw evidence that recommended actions were being undertaken and documented by the provider.
• Safety checks for the emergency oxygen and defibrillator were undertaken on a regular basis and documented by staff.
• A review of prescription stationery security had been undertaken at the branch location and the provider was assured that systems and processes were safe and accountable.
• A medical grade cool box had been obtained to ensure the safe transportation of temperature sensitive medicines between locations.
• The provider had reviewed their approach to national screening programmes and had identified a lead clinician to monitor performance in cervical screening.
• Membership of the patient group continued to be promoted by the provider which had increased to 20 members following a recent text message campaign.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services

Letter from the Chief Inspector of General Practice

We carried out an inspection of Horton Park Medical Practice on 18 November 2014 as part of our comprehensive programme of inspection of primary medical services.

We have rated the practice as providing a good service overall. Details of these findings are in the following report, but in summary our key findings were as follows:

• The staff made effective use of clinical supervision and staff meetings to ensure the practice worked collaboratively with other agencies to improve the service of people in the community.

• All the patients who completed CQC comment cards, and those we spoke with during our inspection demonstrated that the staff had a supportive attitude.

• The practice had an effective complaints policy and responded appropriately to complaints about the practice.

• The leadership team were effective and had a vision and purpose for the practice. There were systems in place to drive continuous improvement.

• There were good infection control processes and the practice was visibly clean and well kept.

Patients were treated with kindness and respect and patients’ needs and effective communication with patients appeared to be the priority for the practice.

Sincerely,

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. However, we have rated this practice as requires improvement for providing safe services. The provider was previously inspected in November 2014 when it was rated as good.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Horton Park Medical Practice on 22 and 25 May 2018 as part of our inspection programme.

At this inspection we found:

• The practice had a number of 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, we saw that fire and legionella risk assessments were out of date or had not been acted upon and prescription security at the branch site needed to be improved.
• 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. There was widespread use of clinical templates to support diagnosis and treatment.
• Staff involved and treated patients with compassion, kindness, dignity and respect. Patient comments we received during the inspection were highly positive about the care and attitude of staff.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it. A daily walk-in clinic for urgent problems was receiving positive feedback since its introduction in April 2018.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. There was a programme of clinical audit and a reduction in the number of GP partners had led to the development of a comprehensive strategic plan to effectively manage change.

The areas where the provider should make improvements are:

• Undertake a fire drill at the branch surgery, to be assured that staff are able to follow the fire procedure and keep patients safe.
• Ensure that a schedule of fire risk and risk of legionella infection assessments continue to be undertaken at both the main and branch location, ensuring that identified actions are acted upon in a timely way to be assured that systems are safe and that risks are minimised.
• Continue to document safety checks for the emergency oxygen and defibrillator to be assured they are fit for use in an emergency.
• Complete the review of prescription security at the branch location and implement identified actions to be assured that risks are minimised.
• Review the method of transportation of vaccines from the main site to the branch site, ensuring that a medical grade cool box is used to be assured that the cold chain is maintained.
• Review and improve exception reporting performance as measured by the Quality and Outcomes Framework (QOF) in order to improve the care and treatment received by their patient population.
• Continue to develop their approach to increase uptake of childhood immunisations and the cervical screening programme.
• Continue to develop their approach to increase the uptake of bowel and breast cancer screening.
• Continue and sustain efforts to relaunch the ‘virtual’ patient participation group to improve the role of the patients’ voice in the development of the practice.

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.