The Ivy Court Surgery

Updated 9 June 2023

The Ivy Court Surgery is located in:

Recreation Ground Road,

Tenterden,

Kent,

TN30 6RB.

The Ivy Court Surgery provides dispensary services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy. This service is delivered by a dispensary manager and five dispensers. The GPs, nurses and dispensers are supported by a practice manager and a team of administration and reception staff. A wide range of services and clinics are offered by the practice including: asthma, diabetes, weight management minor surgery and diagnostic ultrasound.

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

The practice is situated within the Kent and Medway Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 15,000. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices. The practice works with three neighbouring GP practices located in Woodchurch, Charing and Hamstreet as part of a GP collaboration and covers 40,000 patients.

Information published by Office for Health Improvement and Disparities shows that the practice is in one of the least deprived areas in the Kent.

According to the latest available data, the ethnic make-up of the practice area is 0.7% Asian and 97.9% White.

The practice has more patients aged over 64 years and fewer patients aged nine years and under than national averages. There are more male patients registered at the practice compared to females.

There is a team of 11 GPs who provide cover at the practice. The practice has a team of 7 nurses who provide nurse led clinics for long-term conditions. The GPs are supported at the practice by a team of reception/administration staff. The practice manager and operations manager are based at the main location to provide managerial oversight.

The practice is open between 8am to 6.30 pm Monday to Friday, and 8am to 11am Saturday mornings. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Enhanced Access appointments available across the Primary Care Network between 6.30pm and 8pm, Monday to Friday.

Out of Hours provision was commissioned by Kent & Medway Integrated Care Board (ICB) and fulfilled by NHS 111 and SECAmb (South East Coast Ambulance Service).

Updated 9 June 2023

We carried out an announced comprehensive inspection at The Ivy Court Surgery on 15 December 2022. Overall, the practice is rated as good.

Safe - Good

Effective – Requires Improvement

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 26 June 2018, the practice was rated outstanding overall and for responsive and well-led and good for all other key questions.

At the last inspection June 2018 we rated the practice as outstanding for providing well-led services because:

• The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.

At this inspection, we found that those areas previously regarded as outstanding practice were now embedded throughout the majority of GP practices. While the provider had maintained this good practice, the threshold to achieve an outstanding rating had not been reached. The practice is therefore now rated good for providing well-led services.

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

Why we carried out this inspection

We carried out this comprehensive inspection as the practice had not been inspected since June 2018. This inspection was conducted to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

How we carried out the inspection/review

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 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 found that:

• Staff were consistent in supporting people to live healthier lives through a targeted and proactive approach to health promotion and prevention of ill-health, and every contact with people is used to do so.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• 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.
• Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Continue to ensure that controlled drugs (CDs) delivered to patients are signed out of the CD register until the delivery driver returns to the pharmacy with proof of delivery.
• Continue to monitor and review their action plan in relation to the management of patients prescribed high risk medicines, for example, Angiotensin-converting enzyme (ACE) inhibitors (used primarily for the treatment of high blood pressure and heart failure).
• Continue to monitor and improve the practice’s system for acting on Medicines and Healthcare products Regulatory (MHRA) safety alerts to help ensure processes are being followed and embedded.
• Embed systems and processes around the monitoring and review of patients diagnosed with chronic kidney disease stage 4 or 5, diabetic retinopathy, hypothyroidism and potential missed diagnosis of chronic kidney disease stage 3, 4 or 5.
• Embed systems and processes in relation to the monitoring of patients prescribed more than 12 short acting beta agonist (SABA) inhalers in the last 12 months.
• Continue to monitor and review their action plan in relation to the management of patients diagnosed with chronic kidney disease stage 4 or 5, diabetic retinopathy, hypothyroidism and potential missed diagnosis of chronic kidney disease stage 3, 4 or 5.
• Continue to monitor their action plan in relation to patients who had been prescribed more than 12 short acting beta agonist (SABA) inhalers in the last 12 months.

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