Horizon Healthcare

Updated 15 September 2022

Horizon Healthcare is located at Catherine House 2b, Stoughton Drive North, Leicester, LE5 5UB. The main surgery is situated in a recently converted building which has allocated car parking. Horizon Healthcare also has a branch surgery at Loughborough Road Medical Centre, 30-32 Loughborough Road, Leicester, LE4 5LB. Patients can access services and appointments at both sites and we visited both sites during this inspection.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

Horizon Healthcare is situated within the NHS Leicester, Leicestershire and Rutland Integrated Care Board (LLR ICB) and delivers General Medical Services (GMS) to a patient population of approximately 9,400. This is part of a contract held with NHS England. An Integrated Care Board (ICB) is a statutory organisation bringing the NHS together locally to improve population health and establish shared strategic priorities within the NHS.

The practice is part of the Leicester Foxes Primary Care Network (PCN) which is a network of seven local GP practices working collaboratively to deliver improved levels of care for patients, by connecting the primary healthcare team across the area with community and other service providers in their area.

The senior partner is also the registered manager and there are two other GP partners. The provider also has one salaried GP and four long-term locum GPs. The nursing team consists of one practice nurse, one long-term locum practice nurse, and two healthcare assistants. The practice employ their own pharmacist. A business manager and practice manager are supported by the reception and administration team.

The practice has access to staff working across their Primary Care Network (PCN) including a social prescriber, care navigator and additional pharmacist support.

Information published by Public Health England shows that deprivation within the practice population group is in the fourth lowest decile (four of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the estimated ethnic make-up of the practice area is 63.7% Asian, 26.6% White, 4.3% Black, 2.5% Mixed and 2.9% Other.

The practice is open from 7am until 6.30pm Monday to Friday. The 7am opening time applies to the main site on a Monday, Wednesday and Friday, and to the branch site on a Tuesday and Thursday morning. The opening time is at 8am on other days. When the practice is closed, out of hours cover for emergencies is provided by Leicester City Healthcare Hub.

Updated 15 September 2022

We carried out an announced inspection at Horizon Healthcare on 11 August 2022. Overall, the practice is rated as Good.

At our previous inspection on 29 July 2021, the practice was rated Good overall and for the key questions of effective, caring, responsive and well-led, but was rated as requires improvement for providing safe services. In addition, it was rated as requires improvement for the population group of long-term conditions within the effective key question (the effective key question however was rated as good overall).

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

Why we carried out this inspection.

This inspection in August 2022 was a focused review of information including a site visit to follow up on the regulatory breach notice issued after the 2021 inspection.

We inspected elements of the safe and effective key questions which led to the regulatory breach in 2021, and also the areas identified as ‘shoulds’ for the provider to action at the previous inspection.

The previous ratings for the key questions of effective, caring and well-led are carried forward from the previous inspection. Population groups are no longer rated individually, so we reviewed the previous requires improvement rating for people with a long-term condition within the effective key question.

The key question of safe is now rated good and the overall rating of good remains unchanged. Whilst we did not rate the effective key question, we observed that the practice had addressed our concerns relating to long-term condition management. In addition, they had undertaken a range of interventions to improve the uptake of childhood vaccinations and cervical screening, although work remained ongoing to meet national targets.

However, we have rated the key question of responsive as requires improvement as the branch surgery’s facilities and premises were not of an appropriate standard for the services being delivered to patients.

How we carried out the inspection

Throughout the pandemic the Care Quality Commission (CQC) has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing
• Completing remote clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting evidence from the provider to be submitted electronically
• 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 Good overall

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm. The practice had developed effective systems to monitor patients prescribed high-risk medicines and to review medicines safety alerts.
• Patients received effective care and treatment that met their needs. The service had good systems to identify patients at risk of developing diabetes and supported them via treatment and education programmes.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way. However, the branch site required extensive refurbishment work to improve the environment and adhere to best practice in infection prevention and control guidance.

We found one breach of regulations. The provider must:

• Ensure all premises and equipment used by the service provider is fit for use.

In addition, the provider should:

• Develop a protocol to reduce the duration of repeat issues of high risk medicines to try and gain improved compliance from the patient.
• Continue to increase the uptake of childhood immunisations and cervical screening.

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