High Glades Medical Practice

We carried out an announced comprehensive inspection at High Glades Medical Practice on 22 and 23 January 2019. The overall rating for the practice was good. The full comprehensive report on the January 2019 inspection can be found by selecting the ‘all reports’ link for High Glades Medical Practice on our website at www.cqc.org.uk.

After our inspection in January 2019 the practice wrote to us with an action plan outlining how they would make the necessary improvements to comply with the regulations.

This inspection was an announced focussed follow-up inspection carried out on 31 January 2020 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 on 22 and 23 January 2019. This report covers findings in relation to those requirements.

Overall the practice is now rated as Good.

The key question at this inspection is rated as:

Are services effective? – Good.

At this inspection we found:

• The practice had made security improvements so that only authorised persons were able to access staff only areas of the premises.
• We saw that all patient group directions were being kept up to date.
• Medicines that required refrigeration were now being stored in line with Public Health England guidance at all times.
• The practice had worked with the local Clinical Commissioning Group to reduce the prescribing of hypnotics.
• The practice had made improvements to their performance (significantly so in some cases) when caring for patients with long-term conditions as well as patients with poor mental health.
• The practice had enhanced systems so that they were able to identify and follow up children living in disadvantaged circumstances and who were at risk.

The areas where the provider should make improvements are:

• Continue to reduce the prescribing of hypnotics where appropriate.
• Continue to implement and monitor actions to improve performance for diabetes and hypertension indicators.

Dr Rosie Benneyworth MB BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

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

This practice is rated as Good overall.

The key questions at this inspection 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 High Glades Medical Practice on 22 and 23 January 2019 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:

• There was an effective system for reporting and recording significant events.
• The practice’s systems, processes and practices helped to keep people safe.
• Risks to patients, staff and visitors were assessed, monitored and managed in an effective manner.
• Staff had the information they needed to deliver safe care and treatment to patients.
• The arrangements for managing medicines in the practice helped keep patients safe.
• The practice learned and made improvements when things went wrong.
• Performance for diabetes, asthma, COPD, hypertension and mental health related indicators for 2017 / 2018 was significantly below local and national averages. The practice demonstrated innovation in the way they were addressing performance issues. However, action was ongoing.
• Published results showed the childhood immunisation uptake rates for the vaccines given were higher than the target percentage of 90% or above in all four indicators.
• Staff had the skills, knowledge and experience to carry out their roles.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
• Results from the national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was in line with local and national averages.
• There were clear responsibilities, roles and systems of accountability to support good governance and management locally and at provider management team level.
• The practice had a vision to deliver high quality care and promote good outcomes for patients. However, none of the staff we spoke with were aware of the vision.
• There were processes and systems to support good governance and management locally and at provider management team level.
• The practice was proactive at involving patients, the public, staff and external partners to support high-quality sustainable services.

The areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Revise the security of staff only areas of the practice to restrict access by unauthorised persons.
• Continue to ensure all patient group directions are kept up to date.
• Continue to implement and monitor the action plan in response to the monitoring of the temperature of refrigerators used to store medicines and consider introducing inventories of medicines stored at the practice as well as keep records of any audit checks.
• Continue to work with the local Clinical Commissioning Group to reduce the prescribing of hypnotics.
• Continue to implement and monitor the action plan to further enhance systems to identify and follow up children living in disadvantaged circumstances and who were at risk.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

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