9 August 2023
During an inspection looking at part of the service
We carried out an announced inspection at Dr HP Borse & Partner on 9 August 2023. Overall, the practice is rated as good.
Safe - requires improvement.
Effective -good.
Responsive – good.
Well-led – good.
Following our previous inspection on 21 September 2022, the practice was rated requires improvement overall in particular safe, effective and well led.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr HP Borse & Partner on our website at www.cqc.org.uk
Why we carried out this inspection.
We carried out this inspection to follow up breaches of regulation from a previous inspection.
The focus of our inspection included:
- Safe, effective, responsive and well led domains.
- A follow up on the breaches of regulations and advisory actions identified in our previous inspection.
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.
- 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 site visit.
- Staff feedback questionnaires.
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 found that:
- Improvements had been made in the majority of areas identified at the last inspection 21 September 2022 as requiring improvement. However, there were some improvements to be made in the practice systems for recruitment.
- Patients received effective care and treatment that met their needs.
- Patients could access care and treatment in a timely way.
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Medicines and Healthcare products Regulatory Agency alerts were not always promptly actioned.
- Blood monitoring test results were not always either downloaded into the practice electronic systems or documented within the consult record prior to repeat prescribing for disease-modifying anti-rheumatic drugs (DMARDs). The dose of medicine prescribed also did not include day of week in this was to be taken.
- 8 out of 20 patients prescribed a potassium sparing diuretic had not been in receipt of the required monitoring.
- Asthma medicine review consultation records lacked detail.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
We found a breach of regulations. The provider must:
- Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
The provider should:
- Take action to improve cervical screening uptake.
- Implement a system to improve patient compliance with medicine monitoring.
- Consider the practice nurse workload when workforce planning.
- Evaluate the effectiveness of the new management systems instigated and ensure these become embedded and are sustained.
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 Health Care