Grange Street Surgery

Updated 10 October 2022

Grange Street Surgery is located in St Albans, Hertfordshire. The practice is situated within the Hertfordshire and West Essex Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a population of approximately 10,368. This is part of a contract with NHS England. The practice operates from one site. The practice is part of a wider network of GP practices within the Alban Health Primary Care Network (PCN). The practice provides training to doctors studying to become GPs.

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.

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

According to the latest available data, the ethnic make-up of the practice area is 85% White 7% Asian, 7% 3% Mixed 2% Black, and 0.8% Other.

The age distribution of the practice population closely mirrors the local and national averages.

There is a team of two male and one female GP Partners, four female salaried GP’s and two trainee GP’s who provide clinical services at the practice. There are two practice nurses who provide nurse led clinics for long-term conditions. They are supported by three health care assistants. In addition, the practice employs a clinical pharmacist and a care co-ordinator. The GPs are supported at the practice by a team of reception/administration staff. The practice manager provides managerial oversight.

The practice is open between 8.30am to 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

There is extended opening from 7am every Wednesday and until 8pm every Monday and from 8.30am to 10.30am one in every four Saturdays. When the service is closed patients can call NHS 111 for advice and treatment through a local out of hours service.

The practice operates from a three-story premise. Patient consultations and treatments take place on the ground and first floor. The third floor is used by administrative staff only. There is a car park outside the surgery.

Updated 10 October 2022

We carried out an announced inspection at Grange Street Surgery on 31 August 2022. Overall, the practice is rated as Good.

The key questions are rated as:

Safe - Good

Effective - Good

Caring - Not inspected, rating of good carried forward from previous inspection

Responsive - Not inspected, rating of good carried forward from previous inspection

Well-led - Good

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

Why we carried out this inspection

This inspection was a focused inspection. We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

How we carried out the inspection

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 using video conferencing
• Completing 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
• 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.
• 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.
• 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.
• 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:

• Undertake annual fire risk assessments.
• Improve processes in place to ensure infection prevention and control policies are regularly reviewed and updated in line with national guidance.
• Embed identified improvements in medicines monitoring processes.
• Continue to ensure information is managed in line with current guidance and relevant legislation.
• Undertake a review of processes in place to monitor cervical cancer screening uptake in line with national targets.
• Improve patient access to appropriate health assessments and checks.
• Embed and ensure staff understand the vision, values and strategy.
• Develop staff access to the Freedom to Speak Up Guardian for the practice.
• Continue to find ways, such as a patient participation group, to engage with patients and seek their feedback.

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