Lakeside Healthcare at Eaton Socon had been inspected previously on the following dates: -

3 December 2018 under the comprehensive inspection programme as part of our inspection of the provider (Lakeside Healthcare Partnership).

The practice was rated as Good overall with a Requires Improvement for providing a well-led service. All the population groups were rated as Good. A breach of legal requirements was found in relation to governance arrangements within the practice. A requirement notice was issued which required them to submit an action plan on how they were going to meet this requirement.

We carried out an announced focussed inspection at Lakeside Healthcare at Eaton Socon on 15 May 2019 as part of our inspection programme.

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 good overall.

We have rated the practice as Good for providing a well-led service because we found that they had made a lot of improvements to ensure good governance in accordance with the fundamental standards of care.

• The practice’s systems for appropriate and safe handling of patient safety alerts and medicines needed further work to ensure they were fully embedded.
• Risks had been reviewed since the last inspection and outstanding actions had been completed.
• A system was in place to monitor and embed NICE guidance in clinical practice.
• The training and appraisal of staff had been reviewed. Further work was required to ensure all staff had completed the required training and appraisals were completed and signed.
• A new template had been put in place to ensure relevant staff received clinical supervision.
• The practice had taken steps to improve the identification and support for carers.
• Improvements to patient access had been put in place since the St Neots Hub had been put in place and patient satisfaction would be monitored.

The areas where the provider should make improvements are:

• Continue to monitor the systems in place for the appropriate and safe handling of patient safety alerts and medicines.
• Continue to monitor the training, development and clinical supervision of all staff.
• Continue to monitor and improve patient satisfaction in respect of access to the service.

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

We carried out an announced comprehensive inspection at Lakeside Healthcare at Eaton Socon on 3 December 2018 as part of our inspection of the provider (Lakeside Healthcare Partnership).

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 good overall and good for all population groups.

This means that:

• We found effective systems were in place to promote adult and child safeguarding, however, not all staff were up to date on their safeguarding refresher training.
• The provider’s performance in the 2017-18 Quality and Outcomes Framework (QOF) was generally in alignment with local and national averages with the exception of one asthma indicator.
• The practice was proactive in managing child immunisations and worked closely with the health visiting team to ensure vulnerable patients were included.
• There had been changes made to bring antimicrobial prescribing in line with local and national averages and this was continuing to demonstrate improvement.
• Complaints were managed appropriately.
• There was a scheduled audit plan in place and audits showed patient care was improved as a result.
• We found an open and supportive culture within the practice. Staff felt valued and told us they found the GPs and nurses to be accessible and approachable.
• The provider and the practice had a clear vision and values in place and staff were observed to act in line with them.

We rated the practice as requires improvement for providing well-led services because:

• The overall governance arrangements were not always effective and there was not always the capacity to ensure oversight of areas such as staff training and appraisals.

The areas where the provider should make improvements are:

• Consider an effective process, to ensure staff training, the practice deems as mandatory is up to date.
• Continue to improve the identification of carers to enable this group of patients to access the care and support they require.
• Continue to monitor and improve levels of patient satisfaction, in particular in relation to access.
• Consider an effective system to monitor and embed NICE guidance in clinical practice.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

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