Sheen Lane Health Centre

Updated 28 October 2022

Richmond General Practice Alliance (RGPA) is an independent health provider which is a federation of 25 member practices and six PCNs. This service is registered to carry out diagnostic and screening procedures along with treatment of disease, disorder and injury.

The head office is based on the second floor of Hampton Wick Surgery. RGPA previously provided care from three sites: Hampton Wick Surgery, Essex House Surgery and Sheen Lane Surgery. From October 2022 RGPA will not be providing care from Hampton Wick Surgery. The GP practices at these locations provide consultation rooms, equipment, patient reception and waiting areas and reception staff, under a contract with Richmond General Practice Alliance (RGPA), who are responsible for the care delivered. At Essex House the RGPA provides extended access hubs. At Sheen Lane Surgery the RGPA provides microsuction services. RGPA is led by three GP board members.

How we inspected this service

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 28 October 2022

This service is rated as Good overall. (Previous inspection 16 March 2022 – Inadequate)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Richmond General Practice Alliance by visiting its three registered locations of Hampton Wick Surgery, Sheen Lane Health Centre and Essex House to follow up on concerns found at our last inspection in March 2022. This was the second CQC inspection of these locations under the current CQC inspection methodology, since the service registered with CQC in 2016.

Hampton Wick Surgery is the headquarters of the federation Richmond General Practice Alliance (RGPA) which is made up of 25 member practices across Kew, Sheen, Barnes, Richmond, Twickenham, Hampton and Teddington. They provide hub support and governance of six primary care networks (PCNs) for the member GP practices and additional healthcare services to the patient population. This includes extended access and microsuction services. Microsuction is a specialist service for patients who require treatment for their ears.

CQC inspected the service on 16 March 2022 and found breaches of regulations 12 and 17. We asked the provider to make improvements regarding the following areas:

• The way the service was led and managed did not promote the delivery of high-quality care. Governance policies had been established without considering the way that care was delivered, and where policies specified processes these had not been implemented.
• The service did not have good systems to manage risks to patient and staff safety.
• There was insufficient oversight and assurance of this service which meant that care was not consistently safe and effective.
• The service did not have effective systems to ensure that all staff involved in delivering the service were suitable and appropriately qualified for their roles or to ensure that all staff received an appropriate induction and ongoing training.
• The service did not have good systems to ensure that all patients received effective care and treatment.

We checked these areas as part of this comprehensive inspection and found these areas of concern had been resolved.

One board member of the federation is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

• The management team had worked hard to implement improvements since the last inspection throughout their governance arrangements.
• Policies, protocols and communication with all three locations had improved and developed so that there was good consistent care across the provider’s locations.
• There were effective processes in place to ensure patient and staff safety.
• The service had suitable systems to ensure all staff had recruitment checks in place and adequate training.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The service organised and delivered services to allow patients to access care and treatment in a timely way.
• The service had good systems to ensure that all patients received effective care and treatment.
• Clinical records showed improvements were being made throughout this year since the last inspection in regards to safety netting and details of consultations.
• Staff surveys had not yet been completed to enable complete involvement for staff in the vision and future of the service.

The areas where the provider should make improvements are:

• All staff should be involved in a feedback process which ensures continual improvement and strong internal positive culture.

This service was placed into special measures following the last inspection in March 2022. The service made sufficient improvements so that it will now be taken out of special measures.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services