The Wellington Practice

We carried out an announced comprehensive inspection at The Wellington Practice on 11 January 2023. Overall, the practice is rated as Requires improvement.

We rated the key questions as follows:

Safe - Requires improvement

Effective - Requires improvement

Caring - Good

Responsive - Good

Well-led - Requires improvement

The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Wellington Practice on our website at www.cqc.org.uk

Why we carried out this inspection

The Wellington Practice is a new provider which registered with the Care Quality Commission (CQC) on 9 February 2022. We carried out this inspection because the new provider has never been inspected.

How we carried out the inspection.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing facilities.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

Our findings

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 Requires improvement overall. We rated the key questions of caring and responsive as Good. We rated the practice as Requires improvement for providing safe, effective and well-led services because:

• Staff were not up to date with mandatory training required by the practice.
• Infection prevention and control systems did not always follow national guidance.
• Recruitment systems did not always operate in accordance with the regulations.
• Systems to ensure prescription stationery was stored securely when in use were not operating effectively and did not follow national guidance.
• Systems to keep patients safe did not always operate effectively or follow national guidance.
• Systems to respond to safety alerts from the Medicines Healthcare products and Regulatory Agency were not operating effectively.
• Patients with long-term conditions or taking high-risk medicines did not always receive care in line with national guidance.
• Clinical supervision existed but it was not fully embedded throughout the practice for all clinical healthcare staff.
• Governance systems did not always operate effectively or ensure processes followed national guidance.
• Systems and processes to identify, manage and mitigate risks did not always operate effectively or respond sufficiently to the risk.

However, we also found that:

• The practice showed kindness and respect to patients, and it understood the personal and cultural needs of its population, particularly their Nepalese patients.
• There was a system to identify and learn from significant events.
• When things went wrong, staff were open and honest in their apology.
• The practice worked effectively with partners to ensure patients received care in a timely manner.
• The practice actively sought feedback and used it to drive improvement.
• Patients could access care in a timely manner and in a way that suited their needs.
• Patients were highly positive in their feedback and had confidence and trust in the staff and practice.
• The way the practice was led and managed promoted the delivery of person-centred care.

We found three breaches of regulations. The provider must:

• 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.

In addition, the provider should:

• Continue to develop a full programme of audit and quality improvement activity.
• Continue to improve uptake of screening appointments for all eligible patients.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services