We carried out an announced inspection at Tower Hill Partnership on 10 August 2021. Overall, the practice is rated as Good.
The ratings for each key question are as follows:
Safe - Good
Effective – Requires Improvement
Caring - Good
Responsive - Good
Well-led - Good
Following our previous inspection on 24 February 2020, the practice was rated Requires Improvement overall and for the key questions, effective, responsive and well led, but inadequate for providing safe services and good for providing caring services.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Tower Hill Partnership on our website at www.cqc.org.uk
Why we carried out this inspection
This inspection was a comprehensive review of information which included a site visit to follow up on:
- A breach in Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment.
- A breach in Regulation 17 HSCA (RA) Regulations 2014 Good governance.
- Areas we identified the provider should make improvements.
How we carried out the inspection/review
Throughout the pandemic 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
- Completing clinical searches on the practice’s patient records system and discussing findings with the provider
- Requesting evidence from the provider
- 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 and for all population groups except for families, children and young people and working age people which we have rated as requires improvement.
We found that:
- Systems had been strengthened to ensure safeguarding registers were monitored effectively. Regular reviews of the registers were carried out to ensure all the relevant information had been recorded appropriately and safeguarding arrangements protected patients from avoidable harm.
- The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. This included individual risk assessments for staff, the use of personal protective equipment (PPE) and enhanced infection control procedures.
- Governance arrangements had been strengthened to ensure risks to patients were considered, managed and mitigated appropriately.
- Effective procedures for the management of medicines had been strengthened to ensure patients received the appropriate reviews. This included the appropriate monitoring of patients on high risk medicines.
- Action plans were in place to review quality indicators and regular audits were completed to improve patient outcomes.
- Risk management processes were in place and we found assessments of risks had been completed. These included fire safety, health and safety, and infection control. This ensured that risks had been considered to ensure the safety of staff and patients and to mitigate any future risks.
- Patients received effective care and treatment that met their needs.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- Continuous monitoring of practice procedures, clinical outcomes and clinical registers was in place to ensure improvements were maintained.
- The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
Whilst we found no breaches of regulations, the provider should:
- Continue to encourage patients to attend cervical screening appointments.
- Encourage patients to attend childhood immunisation appointments.
- Continue to strengthen processes for the reviewing and actioning of safety alerts.
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 Primary Medical Services and Integrated Care