We carried out an announced comprehensive inspection at Howard House on 5 October 2022. Overall, the practice is rated as good.
Safe - Good
Effective - Good
Caring - Good
Responsive - Good
Well-led - Outstanding
When this service registered with us, it inherited the regulatory history and ratings of its predecessor. This is the first inspection of Howard House Surgery under the registered provider Suffolk Primary Care (SPC) who became the provider from April 2020. Following our previous inspection, under the previous provider the practice was rated good overall. Suffolk Primary Care is a partnership of eight GP surgeries covering a population of 115,00 patient across Suffolk. We inspected eight of the nine practices within a period of four weeks.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Howard House Surgery on our website at www.cqc.org.uk
Why we carried out this inspection
We carried out this comprehensive inspection to provide a rating of the location under the new provider and in line with our inspection priorities.
How we carried out the inspection
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.
This included:
- Conducting staff interviews using video conferencing.
- Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
- A short site visit.
- Staff questionnaires.
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:
- There was compassionate, inclusive and effective leadership at all levels. Leaders at all levels demonstrated the high levels of experience, capacity and capability needed to deliver excellent and sustainable care. There was a deeply embedded system of leadership development and succession planning, which aimed to ensure that the leadership was comprehensive and included successful leadership strategies to ensure and sustain delivery and to develop the desired culture. Leaders had a deep understanding of issues, challenges and priorities in their service, and beyond.
- The strategy and supporting objectives and plans were in place at provider level and at practice level. They were stretching, challenging and innovative, while remaining achievable.
- There was strong collaboration, team-working and support across all functions and a common focus on improving the quality and sustainability of care and people’s experiences.
- Governance arrangements were proactively reviewed and reflected best practice. A systematic approach was taken to working with the other practices within the group, the local primary care network and the provider to improve care outcomes.
- There was a demonstrated commitment to best practice performance and risk management systems and processes. The provider and practice reviewed how they functioned and ensured that staff at all levels had the skills and knowledge to manage those systems and processes effectively. Problems were identified and addressed quickly and openly.
- The service invested in innovative and best practice information systems and processes. The information used in reporting, performance management and delivering quality care was consistently found to be accurate, valid, reliable, timely and relevant. There was a demonstrated commitment at all levels to sharing data and information proactively to drive and support internal decision making as well as system-wide working and improvement.
- There were consistently high levels of constructive engagement with staff and people who use services, including all equality groups.
- There was a fully embedded and systematic approach to improvement, which made consistent use of a recognised improvement methodology. Improvement was seen as the way to deal with performance issues and for the organisation to learn. Improvement methods and skills were available and used across the organisation, and staff were empowered to lead and deliver change.
- The provider had been informed they had been short listed for a national award given by the Health and Safety Journal in the patient safety category. The nomination was in relation to the significant work the provider and practice had undertaken in the monitoring and management of medicines, including patient safety alerts and high-risk medicines. They told us they were very proud of becoming a finalist and planned a celebration with the staff.
Whilst we found no breaches of regulations, the provider should:
- Continue to monitor the performance for the national programme of childhood immunisations and encourage uptake.
- Continue to monitor the performance for the national cervical screening programme and encourage uptake.
- Continue to monitor the safe prescribing of medicines, including those relating to treatment for urinary tract infections and safety alerts.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services