The Care Quality Commission
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The Andover Health Centre Medical Practice

Overall: Requires improvement read more about inspection ratings

Charlton Road, Andover, Hampshire, SP10 3LD (01264) 321550

Provided and run by:
The Andover Health Centre Medical Practice

All Inspections

During an assessment under our new approach

People could access services when they needed to, without physical or digital barriers, including out of normal hours and in an emergency. People were given support to overcome barriers to ensure equal access. Leaders understood the challenges to patient access and responded to take account of people’s needs, including those with urgent needs. Services were designed to make them accessible and timely for people who were most likely to have difficulty accessing care. The provider prioritised, allocated resources and opportunities as needed to address inequalities and achieve equity of access.

During an assessment under our new approach

The Andover Health Centre Medical Practice is a GP practice and provides a range of primary medical services and is registered with the Care Quality Commission under the Health and Social Care Act 2008 to provide the following regulated activities; diagnostic and screening procedures, family planning, midwifery and maternity services, surgical procedures and treatment of disease, disorder or injury. This announced assessment was undertaken between 25 and 29 January 2024. We carried out our on-site visit on 29 January 2024. We assessed 9 quality statements under the key questions of Safe, Effective, Responsive and Well-led. This included: Learning culture, safeguarding, safe and effective staffing, medicines optimisation, assessing needs, delivering evidence-based care and treatment, how staff, teams and services work together, equity in experience and outcomes and governance, management and sustainability. During our assessment, we found concerns around the management of people’s medicines, care and treatment for people with long-term conditions and people affected by safety alerts which resulted in 3 breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Safe care and treatment, Staffing and Good governance. Following this assessment, the overall rating for The Andover Health Centre Medical Practice has changed from Good to Requires Improvement. You can find more details of our concerns in the evidence category findings.

07/07/2020

During an inspection looking at part of the service

We previously carried out an announced comprehensive inspection at Andover Health Centre Medical Practice on 7 February 2019 as part of our inspection programme. We rated the practice as Good overall, however we found a breach of regulations and rated Safe as Requires Improvement. You can read the full report by selecting the ‘all reports’ link for Andover Health Centre Medical Practice on our website at .

We are mindful of the impact of Covid-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what type of inspection was necessary and proportionate, this was therefore a desk-based review inspection. On 7 July 2020, we carried out the desk-based review to confirm that the practice had carried out its plan to meet the legal requirements in relation to the breach of regulations that we identified at our previous inspection on 7 February 2019.

We found that the practice is now meeting those requirements and we have amended the rating for this practice accordingly. The practice is now rated Good for the provision of safe services. We previously rated the practice as Good for providing Effective, Caring, Responsive and Well Led services.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we carried out our desk-based review
  • a video interview with senior staff at the practice on 7 July 2020
  • information from our ongoing monitoring of data about services and
  • information from the provider.

We have rated Safe as Good because:

  • The practice had implemented a protocol and procedure in place to ensure that all Patient Group Directions (PGDs) were appropriately authorised.
  • The practice had updated the way in which action taken in response to safety alerts was recorded and shared with staff.

The practice had also made improvements since the last inspection in the areas of:

  • Increasing the number of carers registered from 165 at the last inspection in February 2019 to 236 in June 2020. This 43% increase meant the practice now had 1.7% of the registered population identified as having caring responsibilities. The practice also told us about recommencing initiatives to encourage carers to register once the practice premises could be reopened to visitors.
  • Seeking, and preparing to act on, patient feedback. A patient survey had been undertaken in February 2020 and showed a mostly positive response from the 176 patients who took part. Due to the coronavirus pandemic the formulation of an action plan to respond to the feedback had been deferred until September 2020. The 2020 national GP patients survey showed an increase in satisfaction with some aspects of care but continued to indicate below average feedback for accessing appointments.
  • The induction policy and plan had been updated and whilst this was generic it was implemented for all staff.
  • A policy tracking and updating system was in place. This identified when policies required updating and who was responsible. We noted this included the new policy for appropriate completion of PGDs.
  • Unverified data showed the practice had achieved over 98% of the care and treatment reviews include in the Quality and Outcomes Framework (QOF) in 2019/20. We could not access information about exception reporting (people removed from the monitoring standards because of contra indications or failure to attend) because the outcome data had yet to be verified and published.

The areas where the provider should make improvements are:

  • Continue to improve the uptake for cervical screening to achieve the national target of 80%. We noted that appointments for cervical cytology tests were available during evenings and weekends. The practice was also launching a campaign to encourage women under the age of 50 to attend for their tests.
  • Continue to review the method for tracking that practice directed training has been completed and evaluate the range of training the practice requires of each staff group.

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 General Practice

7 Feb 2019

During a routine inspection

We carried out an announced comprehensive inspection at The Andover Health Centre Medical practice on 7 February 2019.

At this inspection we also followed up on breaches of regulations identified at a previous inspection on 11 April 2018, where the practice was rated requires improvement overall.

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 but we have rated the practice as requires improvement for providing safe services.

We rated the practice as requires improvement for providing safe services because:

  • The practice’s safeguarding policies did not reflect the risks of patients accessing online services.
  • Staff recruitment or induction policies were not fully embedded.
  • A Patient Group Directive (PGD) had not been authorised and immunisations were found to have been given under this PGD without the appropriate authorisation. This oversight had been highlighted as an issue at the practice’s previous inspection in April 2018.
  • The practice had not formalised its repeat prescribing process to assure itself that the processes that staff were following were appropriate and safe.

We rated the practice as good for providing effective services because:

  • We saw evidence of clinical audits which demonstrated improvements in clinical care.
  • The practice organised and delivered services to meet patients’ needs.
  • Unverified data provided by the practice demonstrated improvements to its Quality and Outcomes Framework results in all but one population group.

We rated the practice as good for providing caring, responsive and well-led services because:

  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs.
  • The practice had a clear and credible strategy for providing sustainable care.
  • Areas for improvement had been identified by the practice following its previous inspection and we saw evidence of actions plans in place to drive these improvements.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Continue to improve the identification of carers to enable this group of patients to access the care and support they need.
  • Continue to improve QOF indicator outcomes and exception reporting to allow patients to access effective care.
  • Continue to improve the uptake for cervical screening to achieve the national target of 80%.
  • Continue to encourage and review patient feedback to monitor patient satisfaction.
  • Review how the practice maintains full oversight of staff training and records of completion.
  • Review how policies and procedures are consistently implemented regarding staff recruitment and induction.
  • Review how actions from safety alerts are recorded and shared with temporary clinicians.

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

27 November 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of The Andover Health Centre Medical Practice on 27 November 2014. The practice is situated at Charlton Road, Andover, Hampshire. SP10 3LD. The practice is a training practice for GPs.

The practice is rated as good overall.

Our key findings were as follows:

  • Patients were able to access appointments via telephone, online or in person. Extended pre bookable appointments were offered each day from 7.30am with GPs and nurses.
  • Patients told us they were treated with respect and treatment and care options were explained to them.
  • There were suitable systems in place to protect patients from harm and staff were aware of the need to report any safeguarding concerns they had.
  • Arrangements were in place to minimise the risk of cross infection. The practice had a contract to provide palliative care to a local hospice; GPs carried out ward rounds on week days.
  • Alerts were placed on patient records that had type one diabetes to check for coeliac disease. (Coeliac disease is a lifelong autoimmune disease caused by intolerance to gluten).
  • The practice were not always made aware of a woman’s pregnancy as communication was not effective between the practice and the midwifery service. GPs said that midwives had agreed to send information on a weekly basis to the practice but this had not occurred and this issue was ongoing.
  • Palliative care meetings were held every two months and attended by Macmillan nurses and on occasion a consultant in palliative care.

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

The provider should:

  • Provide safeguarding adults training for all staff relevant to their roles.
  • Include information when responding to complaints about access to advocacy services, the Parliamentary Ombudsman or the role of NHS England in complaints handling.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice