Southgate Medical Group is rated as good overall. (Previous inspection 25 March 2015 rated as good 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? – Good

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 – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

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

We carried out an announced comprehensive inspection at Southgate Medical Group on 21 February 2018. The inspection was carried out as part of our inspection programme.

At this inspection we found:

• 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 it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Patient records we saw were clear and accurate in most instances; however one record did not contain full contemporaneous information used to support decisions made.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The practice had appropriate facilities and was well equipped to treat patients and meet their needs.
• Patients said they were able to book an appointment that suited their needs. Pre-bookable, on the day appointments, home visits and phone consultation services were available. However some patients felt it was difficult to get through on the phone and get a pre-bookable appointment.
• The practice recognised that the patient’s emotional and social needs were as important as their physical needs. They took an active part in social prescribing to improve the quality of patient’s health and well-being.
• Recruitment procedures kept patients safe.
• Staff had been provided with appropriate training, supported to develop new skills and received an up to date appraisal.
• Staff were positive about working in the practice.
• Patient survey results were positive and higher than average in some areas in respect of care and treatment.

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Additionally the provider should:

• Review the collation of responses to MHRA alerts to keep a central record that demonstrates actions and outcomes.
• Keep patient feedback in respect of the appointment system and telephone access under review and take action as appropriate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Southgate Surgery on 25 March 2015. We visited the practice location at 137 Brighton Road, Crawley, West Sussex, RH10 6TE.

Overall the practice is rated as good. Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

The inspection team spoke with staff and patients and reviewed policies and procedures. The practice understood the needs of the local population and engaged effectively with other services. The practice was committed to providing high quality patient care and patients told us they felt the practice was caring and responsive to their needs.

Our key findings were as follows:

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Patients said they were treated with compassion, dignity and respect.
• The practice understood the needs of the local population and planned services to meet those needs.
• The practice demonstrated a strong commitment to tackling social isolation and promoting health and well-being for patients.
• The practice engaged effectively with other services to ensure continuity of care for patients.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Staff felt well supported and described a culture of openness, transparency and continuous improvement.

We saw one area of outstanding practice:

• The practice demonstrated a strong commitment to tackling social isolation and promoting health and well-being within the local population. They had developed an ongoing programme of well-being events and activities in which patients were able to participate. For example, the practice had recently hosted a wellness evening which showcased how art, music and exercise could improve patients’ health and well-being. The practice had also set up its own choir to encourage patients to sing and to highlight the benefits of singing to patients suffering from a range of conditions.

However, there were areas of practice where the provider needs to make improvements.

The provider should:

• Ensure learning from incidents is more comprehensively recorded and reflects how learning points identified are followed up.

• Continue to monitor and review patient feedback to ensure GPs involve patients in decisions about their care.
• Continue to review and implement improvements to patients’ access to the practice by telephone.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with four patients who were also members of the practice's Patient Participation Group (PPG). They spoke positively about the services the practice provided. They described the practice as "very supportive, caring and co-operative." They told us about how the practice had worked with them to improve services and provide regular education and "well-being" events for patients.

We spoke with three GPs, the practice manager, the assistant practice manager, two practice nurses, three administrative staff and a phlebotomist. All of the staff we spoke with said how happy they were working for the practice. They all said they received sufficient training and development and felt well supported in their roles. They all received regular supervision and appraisal. One staff member said, "I love it here. Everybody is really professional and supportive."

We found that the practice had policies and procedures in place to safeguard children and vulnerable adults. All staff had received up to date training in these areas and were aware of their roles and responsibilities in relation to this. This meant that patients who used the service were protected from the risk of abuse.

The practice had an effective system to monitor the quality of service that patients received. We saw that the views of patients were sought and acted on through regular surveys and the PPG. There was evidence that learning was implemented as a result of complaints and significant events.

This practice is rated as Good overall. (Previous rating May 2018 – Good)

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

We carried out an announced comprehensive inspection at Southgate Surgery on 21 February 2018. The overall rating for the practice was good. The practice was also rated good for the effective, caring, responsive and well-led domains and all the population groups. However, it was rated as requires improvement for providing safe services. The full comprehensive report on the February 2018 inspection can be found by selecting the ‘all reports’ link for Southgate Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 18 September 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection on 21 February 2018.

This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

At our inspection of 21 February 2018, we found that:

• The provider had not ensured that accurate, complete and contemporaneous records were being maintained securely in respect of each service user. In particular: the contemporaneous patient’s records were not always up to date with patient information related to prescription changes.

At this inspection our key findings were as follows:

• The provider had a system for recording and responding to changes made to patient medicine prescriptions by secondary care clinicians. Accurate records were maintained and supporting documentation was scanned into the patient record as soon as practicable.

Additionally we saw that:

• The provider had a system in place for the collation of responses to Medicines and Healthcare products Regulatory Agency (MHRA) alerts and kept a central record that demonstrated the action taken. These were also discussed at practice meetings.

• The provider continued to review access to the service via the telephone system. A new suite of messages had been recorded to improve information for callers advising them to call at different times to call for results and general enquiries so that the core early morning hours were free for urgent and appointment booking calls. The practice had worked with the telephone provider to assess peak calling times so that staff could be redeployed as necessary.

• We were told that further work had been undertaken to provide additional appointments for under-fives. and additional minor illness appointments had been made available with increased capacity in the nursing team.

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.