Background to this inspection
Updated
13 August 2021
Chatham Street Surgery is located in a purpose-built health centre and is situated in the heart of Reading town centre. There are approximately 7,200 registered patients with approximately 300 new or returning patients registering each year.
All services are provided from:
- 121 Chatham Street, Reading, Berkshire, RG1 7JE
The practice website is: www.chathamstreetsurgery.co.uk
Chatham Street Surgery is a practice within the Berkshire West Clinical Commissioning Group (CCG). (A CCG is responsible for planning and designing local health services in a specific geographic area. They do this by 'commissioning' or buying health and care services).
The practice has a mixed patient population. Patients registered at the practice are from many different ethnic backgrounds with no specific background being prominent due to the variety of cultures in Reading. There are a large proportion of the patients who speak English as a second language. The practice also provides care to asylum seekers, homeless people and refugees.
The practice population has a higher than national average patient group aged between 25-34, with a number of patients being working professionals. However, 7% of the practice population has a working status of unemployed compared to the local average of 3% and the national average of 4%. National data shows the practice ranked five in a scale of one to 10 for economic deprivation (with 10 least deprived and one most deprived). People living in more deprived areas tend to have greater need for health services. The practice also has a transient patient population with patients often outside of the country for long periods. This has an impact on screening and recall programmes.
There are four GPs at the practice comprising two partners and two long term locums. The GP sessions held at the practice equate to 3.75 whole time GPs. The all-female nursing team consists of an advanced nurse practitioner, a practice nurse and two phlebotomists with a mix of skills and experience.
The regulated activities for which the practice is registered are:
• Treatment of disease disorder and injury
• Maternity and midwifery services
• Diagnostic and screening procedures
• Family planning
• Surgical procedures
The practice is open between 8am and 6.30pm, Monday to Friday. Appointments are offered from 8.30am to 12.50pm every morning and afternoon clinics start at 12pm with the last appointment at 5.30pm daily. Extended hours appointments are offered on a Monday at the practice and at other GP surgeries in the local area from Tuesday to Sunday as part of federated arrangements.
The practice has opted out of providing out of hours services to their patients. Out of hours services are provided by Westcall. The out of hours service is accessed by calling NHS 111. There are arrangements in place for services to be provided when the surgery is closed, and these are displayed at the practice and in the practice information leaflet.
Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments have been via telephone consultations. If a clinician decides a patient requires a face-to-face appointment, an appointment is made.
Updated
13 August 2021
We carried out an announced inspection at Chatham Street Surgery in Reading, Berkshire on 4 August 2021.
Following our previous inspection in December 2019, the practice was rated Requires Improvement overall with three key questions (the provision of safe, effective and well-led services) rated as Requires Improvement. The remaining key questions (the provision of caring and responsive services) were rated as Good.
At this inspection (August 2021), we found improvements had been made and the provider is now compliant with the regulations. We have re-rated this practice as Good overall and Good for all population groups, specifically we have rated the practice as:
- Safe - Good
- Effective - Good
- Well-led - Good
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Chatham Street Surgery on our website at www.cqc.org.uk
Why we carried out this inspection
Given continued concerns from a previous inspection in February 2019 and new concerns reported at the December 2019 inspection, we issued a requirement notice for Regulation 12 ‘Safe care and treatment’ and a warning notice for Regulation 17 ‘Good governance’.
A further announced focused inspection was undertaken in October 2020. That inspection reviewed the actions taken by the practice to improve the quality of care and to confirm that the practice was now meeting legal requirements. We were not able to re-rate the practice as a result of this type of remote focused inspection. We used that approach because we wanted to find evidence that confirmed improvements had been made whilst being aware of COVID-19 restrictions in primary care. We saw a variety of evidence which demonstrated improvements had been made, sustained and the practice had complied with the warning notice issued, and the conditions previously imposed on the provider registration.
We carried out an announced inspection on 4 August 2021 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspections in February 2019 and December 2019.
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 remote 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
- A discussion with two patients
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:
- The practice had continued to made improvements since our previous inspections in February 2019, December 2019 and October 2020.
- The practice provided care in a way that kept patients safe and protected them from avoidable harm, including associated risks to the COVID-19 pandemic.
- The practice was able to demonstrate staff had the skills, knowledge and experience to carry out their roles. Staff members were appraised annually and received appropriate supervision and training.
- Data showed an improvement in the outcomes for people with long term medical conditions. However, further improvement should be made in relation to childhood immunisations and cancer screening.
- The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
- The way the practice was led and managed promoted the delivery of high-quality, person-centred care. The practice now had an effective governance system in place, was well organised and actively sought to learn from previous inspections, performance data, complaints, incidents and feedback.
Whilst we found no breaches of regulations, the provider should:
- Continue to monitor and increase childhood immunisations and cervical screening uptake.
- Further improve patient engagement processes through re-engagement with the patient participation group.
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