Chadwell Heath Surgery

Background to this inspection

Updated 11 December 2017

Chadwell Heath Surgery is located in Romford, Essex and holds a Personal Medical services (PMS) contract with NHS England. The practice’s services are commissioned by Redbridge Clinical Commissioning Group (CCG). They are registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury.

The practice is staffed by two GP partners, one female and one male, and two part time, salaried female GPs. The practice also employs an advanced nurse practitioner, two practice nurses, and a healthcare assistant. Also employed are one full-time practice manager, one part-time deputy manager, an IT manager, a secretary and nine reception and administration staff.

Two pharmacists who work two days a week have been employed by both the practice and part-funded by NHS England as part of the clinical pharmacists three year pilot scheme. The practice is also a teaching practice for medical students from a local university.

The practice is open between 9.00am and 8.00pm on Monday, Tuesday, Wednesday and Friday and between 9.00am and 1.00pm on Thursday. The surgery is closed between 1.00pm and 3.00pm on Friday. Extended hours are offered between 6.30pm and 8.00pm on Monday, Tuesday, Wednesday and Friday and pre-booked appointments are offered on Saturday between 10.00am and 1.00pm. Outside of these hours, the answerphone redirects patients to their out of hours provider.

The practice is part of the Healthbridge hub of 15 practices which provides patient access to appointments when the practice is closed and at weekends. The hub is open between 6.00pm and 10.00pm on Monday to Friday and between 9.00am and 5.00pm on Saturday and 9.00am and 1.00pm on Sunday.

The practice has a list size of just over 10,000 patients and provides a range of services including phlebotomy, ECG monitoring, counselling services, postnatal care, childhood immunisations, vaccinations such as yellow fever, chronic disease management and minor surgery including cryotherapy and family planning services.

The practice is located in an area where there is a larger than average population aged between 0-18 years of age. The two main ethnicity groups in the area (42% each) are white and Asian. The practice also provides care to 50 residents in a local residential home and 35 residents in a local nursing home.

Overall inspection

Good

Updated 11 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chadwell Heath Surgery on 11 August 2016. The overall rating for the practice was requires improvement.

We found breaches of the legal requirements and as a result we issued requirement notices in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014 - Good Governance, where the provider had not ensured that:

they had assessed, monitored and mitigated the risks to the health and safety of service users in respect of the proper and safe management of prescriptions;
they had effective and sustainable governance systems and processes in place to assess, monitor and improve the quality and safety of the services provided, including appropriate safeguarding policies and procedures.

and Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) 2014 - Staffing, where the provider had not ensured that:

persons employed had received appropriate training as was necessary to enable them to carry out their duties.

We also issued an Enforcement Notice in relation to Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment, where the provider had not:

fully assessed the risks to the health and safety of service users receiving care and treatment or taken steps to mitigate such risks;
ensured that persons providing the care or treatment to service users had the qualifications, competence skills and experience to do so safely;
had not ensured that the premises used were safe for their intended purpose and used in a safe way;
had not assessed the risk of, and preventing, detecting and controlling the spread of infections.

The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Chadwell Heath Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 19 October 2017 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 inspection on 11 August 2016.

This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

Patients said they were treated with kindness, dignity and respect and they were involved in their care and decisions about their treatment.
All safeguarding policies had been updated and staff trained to the appropriate levels.
The significant event recording process had been overhauled with new protocols and forms in place.
Information about services and how to complain was available and improvements had been made to the quality of care and access to services as a result of complaints and concerns being analysed.
Medicines management policies, specifically as regards monitoring of uncollected prescriptions had been improved.
Data from the national GP patient survey published in July 2017 showed patients rated the practice in line with others for most aspects of care.
Information about the availability of chaperones was evident throught the practice.
Signs were in the waiting room informing patients of the availability of a hearing loop and translation facilities.
There was a clear leadership structure in place and staff felt supported by the management team. The practice responded positively to feedback from staff and patients.
Effective systems were in place for identifying and assessing the risks to the health and safety of patients and staff.
A revised recruiting procedure, training policy and full recruitment checks were now in place.
Patients found it easy to make an appointment, with urgent appointments available the same day.
Governance arrangements had improved. There was effective clinical leadership in place and staff were aware of their roles and responsibilities.
The practice was well equipped to treat patients and meet their needs.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice