The Care Quality Commission
  • Doctor
  • GP practice

The Ivy Court Surgery

Overall: Good read more about inspection ratings

Recreation Ground Road, Tenterden, Kent, TN30 6RB (01580) 763666

Provided and run by:
The Ivy Court Surgery

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about The Ivy Court Surgery on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about The Ivy Court Surgery, you can give feedback on this service.

15 December 2022

During a routine inspection

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

26 June 2018

During a routine inspection

This practice is rated as Outstanding overall. (Previous rating 27/06/2016 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Outstanding

We carried out an announced comprehensive inspection at The Ivy Court Surgery on 26 June 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned 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.

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • The practice used information about care and treatment to make .improvements
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.
  • There was a clear leadership structure and staff felt supported by management.

We saw areas of outstanding practice:

  • There was a community ‘virtual’ ward which met every fortnight to discuss the most complex patients. The virtual ward operates in the same way as a normal hospital ward, the difference is the patient stays comfortably and safely in their own home. The practice ensured a community geriatrician attended their community virtual ward meetings, providing an additional level of clinical input to those complex patients.
  • The community ward and weekend urgent care service had significantly reduced hospital admissions for patients over 75.
  • Ivy Court Surgery was the first practice in Ashford to host an in-house ultrasound service over eight years ago. This year they had improved this service by now offering this service across Ashford, to all local practices, and hosted the service in various sites across the rural cluster.
  • Patients who had been diagnosed with breast, prostate or bowel cancer within the last five years were invited in to the practice for a 45 minute review with a GP who was a fellow in cancer care, for a more holistic review.
  • The practice recognised that mental health problems were not limited solely to patients, and this could also affect their staff. One of their GP partners was heavily involved in running Mindfulness Based Cognitive Therapy (MBCT).

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

13 April 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Ivy Court Surgery on 13 April 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment for patients.
  • The practice provided training and mentorship for future healthcare professionals including trainee GPs and student nurses.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

We saw several areas of outstanding practice:

  • The practice offered a community ‘virtual’ ward which met once a fortnight. Team members included GPs, an elderly care consultant, social care staff, community nurses and representatives from the voluntary sector. The aim of the virtual ward was to help to ensure that patients’ emotional and social needs were met and given equal importance.
  • The practice had recognised their patient list contained a higher than average amount of elderly patients and had chosen to focus on dementia as a particular issue for their population. There was an aim to raise the profile of dementia locally and one of the GP partners collaborated with other healthcare professionals and the Alzheimer’s Society to give a series of talks in the local church. Two members of staff had attended dementia awareness training courses and were being released once a fortnight to support patients and their carers at the local Dementia Café.
  • The practice provided access to services seven days a week through a collaboration with two neighbouring surgeries. This service provided access to urgent appointments at the weekend from 9am to 12pm on Saturday at The Ivy Court Surgery and Sunday at The Hamstreet Surgery for over 25,000 patients. This meant patients did not have to travel to Hospital Accident and Emergency Departments and could access services locally. GPs and staff providing this service had access to patients’ notes providing continuity of care for patients attending urgent care clinics.
  • There were regular consultant led frailty clinics undertaken at the practice. This service was provided through collaboration with neighbouring practices. Sixty seven patients at The Ivy Court Surgery had accessed this service.

The areas where the provider should make improvements are:

  • Continue to identify patients who are also carers and build on the current carers register to help ensure that all patients on the practice list who are carers are offered relevant support if required.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice