We carried out a review of the data available to us about Dr C P Hughes and Partners 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 Dr C P Hughes and Partners, you can give feedback on this service.
We carried out an inspection at Dr C P Hughes and Partners on 9 July 2019.
This inspection was carried out because the practice had breached a regulation at their last inspection in October 2018 and had told us, via an action plan, that they had addressed the concerns that led to the breach. Our monitoring of the practice also identified improvement in management oversight of processes and procedures. We therefore focused on the following key questions: Was the practice providing effective and well-led services.
Because of the assurance received from our review of information we carried forward the ratings for the following key questions: Was the practice providing safe, caring and responsive services.
At this inspection we found the practice had addressed the concerns and breach of regulation found in October 2018. We have rated the practice as good for provision of effective services. The practice had maintained appropriate management and governance arrangements and is also rated good for provision of well-led services.
We have rated this practice as good overall and good for all population groups.
We found that:
Whilst we found no breaches of regulations, the provider should:
Details of our findings and the evidence supporting the change in rating are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care
This practice is rated as Good overall. (Previous inspection January 2015 rating – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Requires improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Dr CP Hughes and Partners on 9 October 2018 as part of our inspection programme.
At this inspection we found:
The areas where the provider must make improvements are:
Additionally the provider should:
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr AR Vernon and Partners at Wallingford Medical Practice, Reading Road, Wallingford, Oxfordshire OX10 9DU on 28 January 2015.
Overall the practice is rated as good.
Specifically, we found the practice to be good for all areas including all the population groups.
Our key findings across all the areas we inspected were as follows:
We saw several areas of outstanding practice including:
However there were areas of practice where the provider needs to make improvements.
The provider should
Chief Inspector of General Practice
Dr A R Vernon and Partners, also known as Wallingford Medical Practice is located in purpose built premises in a semi-rural area in the grounds of Wallingford Community Hospital. The practice has six GP partners and four associate GPs. It provides primary medical services to approximately 16000 registered patients. The practice dispenses prescriptions to approximately 3300 patients.
The practice serves a population which is more affluent than the national average. It also has a higher proportion of patients over the age of 40 years compared to the local Oxfordshire Clinical Commissioning Group (CCG) and national average and lower in the 15-34 year age group.
We visited the practice location at Wallingford Medical Practice, Reading Road, Wallingford, Oxfordshire, OX10 9DU.
We spoke with eight patients and 19 staff during the inspection. We contacted the local clinical commissioning group, NHS England area team and local Healthwatch to seek their feedback about the service provided by Wallingford Medical Practice. We also spent time reviewing information that we hold about this practice.
We found the provider was in breach of the two Regulations: Requirements relating to workers and Supporting workers.
The practice operated from premises that were clean and well maintained. Systems were in place to report and learn from incidents to improve patient safety. However, we did not see an analysis of incidents overall to identify themes or trends. Staff were aware of how to respond appropriately if they suspected abuse in children or adults, although training in safeguarding adults had not been provided. We found a Disclosure and Barring Service (DBS) check was not in place for one nurse and there were no DBS risk assessments for three reception staff. The practice had policies and procedures in place regarding the handling of medicines. We found the practice could not be assured that non-refrigerated medicines were stored within their recommended temperature ranges. Emergency procedures were in place to respond to medical emergencies.
Systems were in place to ensure evidence based practices including national and local guidelines were used and monitored through audits. The practice nurses were trained and experienced in providing diabetes and asthma care to ensure patients with these long term conditions were regularly reviewed and supported to manage their conditions. Staff were supported to undertake core training relating to their role. However, we found two of the nursing staff felt training opportunities could be improved and dispensary staff did not receive regular update training.
We spoke with eight patients during the inspection and reviewed five comment cards. Patients were very positive about the care they received. Negative feedback from patients we spoke with and via practice surveys related to difficulty to contacting the practice to obtain appointments. We observed staff were respectful in their interactions with patients in a way that preserved their dignity and confidentiality. Information for patients on the complaints procedure was also available on the practice website and booklet. All the patients we spoke with said they had never had cause to complain about the care they received from the practice.
The practice operated a flexible appointment system which involved a duty GP to ensure all patients who needed to be seen the same day were accommodated. The practice had made some improvements to the appointment system as a result of patient feedback.
GPs were very positive about the education and training offered by the practice. GPs were aware of what action to take if they judged a patient lacked mental capacity to give their consent. They told us they recorded best interest decisions, involved carers and sought specialist advice if needed. We found all nursing staff had not received training in the Mental Capacity Act 2005.
Staff expressed pride in the practice and described a supportive team environment where individual roles were valued.
The practice considered the needs of older people in the delivery of the service. The GPs involved patients and family in discussions before completion of the do not attempt cardiopulmonary resuscitation form. GPs were aware of what action to take if they judged a patient lacked the mental capacity to give their consent and they acted appropriately.
The practice supported patients with long term conditions to manage their health, care and treatment. The practice nurses were trained and experienced in providing diabetes and asthma care to ensure patients with these long term conditions were regularly reviewed and supported to manage their conditions.
Specific services for mothers, babies, children and young people included weekly antenatal clinics, baby immunisation clinics and baby development clinics.
The practice offered weekly Saturday morning surgeries for routine and urgent appointments, to accommodate the needs of working age people and commuters.
Staff were familiar with the needs of patients with learning disabilities and supported them, for example, by reminding them to attend appointments. One of the practice nurses taught the carers of patients with learning disabilities to administer insulin to facilitate their independence.
The practice was working towards the joint Oxfordshire dementia plan to increase awareness and improve identification of patients at risk of dementia
Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.