Knightwood Surgery

Updated 30 August 2019

Updated 30 August 2019

We carried out an announced comprehensive inspection at ENTVS on 23 July 2019 as part of our inspection programme. This was the service’s first inspection.

ENTVS is one of the services registered with the CQC under the provider, Tri Locality Care Ltd (TLC Ltd). TLC Ltd is a GP federation providing additional NHS services to a group of nine GP practices in the Eastleigh North and Test Valley South region of the West Hampshire locality.

ENTVS is a transformation care service, led in the community. It is designed to provide services to reduce avoidable admissions to local hospitals, such as through medicines optimisation reviews, holistic well-being assessments and social prescribing. This service is intended for the most vulnerable patients from the member practices in the GP federation.

The ENTVS service is also commissioned to provide a phlebotomy service to the practices in the federation. However, this service is sub-contracted to the GP practices themselves so TLC Ltd is not accountable for the regulated activities involved in the phlebotomy service. We therefore did not inspect this service, other than to establish that the provider was seeking appropriate assurances about how the service was being provided by the member GP practices.

The provider’s lead GP is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We did not receive any comment cards from patients using this service. We did not speak to any patients on the day of inspection due to the home-visiting nature of the service.

Our key findings were:

• The service worked in association with the member GP practices and other local services to support those patients identified as most vulnerable.
• Staff had the information they needed to deliver safe, effective and holistic support to patients.
• Patients received co-ordinated and person-centred care.
• Staff treated patients with kindness, respect and compassion.
• The service organised and delivered services to meet patients’ needs.
• Due to the nature of the service, performance data to monitor the service and drive improvement was limited but the service was looking at ways to improve this.
• Leaders were knowledgeable about issues and priorities relating to the quality and future of services. They understood the challenges and were addressing them.
• There were clear responsibilities, roles and systems of accountability to support good governance and management but awareness of these roles and responsibilities were not consistently known from board level down to front-line staff.

The areas where the provider should make improvements are:

• Consider alternative ways of producing performance monitoring data, such as through the identification of themes following medicines reviews, in order to demonstrate the impact the service was having in the locality.
• Review how quality improvement activity can be undertaken in order to drive internal improvement of the service.
• Review how all staff at the service are made aware of board level members’ roles and responsibilities.
• Review the service’s Safeguarding Children’s policy to ensure it correctly reflects its training requirements in line with the national Intercollegiate Document (2019).
• Review training arrangements so that all staff receive Mental Capacity Act 2005 training in a timely way.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care