This practice is rated as Good overall. (Previous rating September 2017 – Requires Improvement)
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 Addison House – Haque Practice on 04 June 2018. This was to follow up on breaches of regulations and provide a new rating for all key questions and population groups.
We previously carried out a comprehensive inspection on 3rd August 2017. This was a comprehensive inspection. At that inspection, we rated the practice as requires improvement overall, with effective and caring rated as requires improvement. This was because the practice had a higher rate of exception reporting and in respect of the caring domain, the practice had not identified a sufficient number of carers. Results from the GP survey showed that patients rated the practice lower than others for some aspects of care.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. The practice had revised their reporting of significant events with a view to promoting an open, accessible and ‘no-blame’ culture. When incidents did happen, the practice learned from them and improved their processes.
- The practice did not record clinician’s immunisation status against measles, mumps and rubella (MMR) nor varicella.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
- The prescribing of some antibiotics was higher than average. The practice had taken steps to improve performance.
- There were not effective systems to routinely review patients who were prescribed lithium.
- There was not an effective system to manage MHRA alerts.
- The practice reviewed the effectiveness and appropriateness of the care it provided. Some improvements had been made to the number of patients who were excepted from QOF data. Improvements had been made to identified areas of underperformance from 2016/17.
- Carers were now being identified and a carers’ champion had been appointed to signpost carers to avenues of support.
- Childhood immunisation uptake rates were now in line with the target percentage of 90% or above.
- Appraisal records were not present and available for all of the nursing team.
- The practice had improved its uptake for cervical screening. Unverified data for 2017/18 showed the number of women who had had a cervical smear in the last five years had increased to 80%.
- Weekly ‘ward rounds’ were carried out a local care home. Patients had a medicine review once a month with a GP and a CCG pharmacist.
- A number of GPs at the practice had a special interest. Internal referrals for specialist advice were made with a view to reducing hospital referrals.
- A neighbourhood clinic was held at the practice on a Saturday morning and all day on Wednesday. Clinicians saw patients from Addison House and those from another practice in the locality.
- Some feedback in the GP patient survey was low although some steps had been taken with a view to improving performance.
- Where it was identified that staff would benefit from additional training in long-term conditions, other health care professionals were invited to provide training at the weekly educational meeting.
The areas where the provider must make improvements are:
- Ensure care and treatment is provided in a safe way to patients
The areas where the provider should make improvements are:
- Record clinician’s immunisation status against measles, mumps and rubella (MMR) and varicella and retain information to evidence the discussion during appraisal.
- Continue to review and improve patient feedback around access and the treatment provided by the nursing team.
- Ensure all appraisal records are available for inspection.
- Continue to monitor and improve performance in respect of antibiotic prescribing and exception reporting.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.