The Hawkinge & Elham Valley Practice

We carried out an announced focused inspection at The Hawkinge & Elham Valley Practice on 29 July 2021.

Overall, the practice is rated as Requires Improvement.

The key questions at this inspection are rated as:

Are services safe - Requires Improvement

Are services effective - Requires Improvement

Are services well-led - Requires Improvement

Following our previous inspection on 17 December 2019, the practice was rated Requires Improvement overall and for safe, effective and well led. The practice was rated good for caring and responsive.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Hawkinge & Elham Valley Practice on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a comprehensive review of information conducted remotely whilst also undertaking a site visit inspection to follow up on:

Performance of the practice in safe, effective and well led domains. In particular, we inspected the management of medicine alerts, and effective systems and processes to help ensure good governance in accordance with the fundamental standards of care.

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 Requires Improvement overall and for people with long-term conditions and Good for all of the other population groups.

We found that:

• The provider had made improvements to the management and records of staff vaccination statuses.
• Appropriate standards of cleanliness and hygiene were met.
• The arrangements for managing medicines did not always keep patients safe.
• The provider had made some improvements to the management of safety alerts. However, further improvements were required.
• Patients’ needs were assessed, but care and treatment were not always delivered in line with current legislation, standards and evidence-based guidance.
• The pandemic had had a detrimental effect on the practice’s ability to deliver some care as well as treatment. However, improvements were required in the record keeping for some types of patient reviews as well as subsequent follow up activities.
• The practice had met the WHO based national target of 95% for all five of the childhood immunisation uptake indicators.
• Staff had the skills, knowledge and experience to carry out their roles. However, improvements to the recording of staff competency and the quality of their clinical records were required.
• There was compassionate as well as inclusive leadership at all levels and the practice had a vision to deliver high-quality care and promote good outcomes for patients.
• The practice’s processes for managing risks, issues and performance were not always effective.
• The practice had systems to continue to deliver services and meet patients’ needs during the pandemic.
• There were systems and processes for learning, continuous improvement and innovation.

We found two breaches of regulations. The provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Whilst we found no breaches of regulations, the provider should:

• Consider revising the recruitment policy to reflect the current practice of accepting staff Disclosure and Barring Service (DBS) checks from previous employers.

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