Arcadian Gardens Surgery

Updated 19 February 2024

Arcadian Gardens Surgery is located at 1 Arcadian Gardens, Wood Green, London, N22 5AB. The practice is situated a short walking distance from Wood Green underground station and is also accessible on several local bus routes.

The provider is registered with CQC to deliver the following regulated activities:

• Diagnostic and screening procedures
• Treatment of disease, disorder or injury

The practice is part of the North Central London Integrated Care System and delivers General Medical Services (GMS) to a patient population of approximately 8,000. Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the fourth lowest decile (four of 10). The lower the decile, the more deprived the practice population is relative to others. Arcadian Gardens Surgery cares for a diverse population (with approximately 29% of its patients from Black and minority ethnic backgrounds).

There is a team of 3 GPs who provide cover at the practice, 2 of whom are GP partners (1 male and 1 female). The practice has a team of 2 advanced nurse practitioners (1 male and 1 female), 1 female practice nurse, a practice manager, and a range of administrative and reception staff.

The practice is open between 8:00am and 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended hours surgeries are also offered Monday to Friday from 6.30pm to 8:30pm and 8:00am to 8:00pm at weekends (via local GP access hubs). Outside of these times, patients are referred to a local out-of-hours provider.

Updated 19 February 2024

We carried out an announced comprehensive inspection at Arcadian Gardens Surgery on 19 December 2023. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring – Not inspected (rating of Good carried forward from previous inspection)

Responsive - Not inspected (rating of Good carried forward from previous inspection)

Well-led - Good

Following our previous inspection on 10 October 2022, the practice was rated Requires improvement overall and for the providing safe and well-led services. The practice was rated Good for providing effective, caring and responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Arcadian Gardens Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up concerns and breaches of regulation from a previous inspection.

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:

• Completing remote 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 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 found that:

• Following our inspection in October 2022, we found the practice did not have effective systems in place to monitor cancer referrals and the recording of cervical smear results. At this inspection, we found the practice had implemented systems to monitor these and had established protocols to ensure these were reviewed in a timely manner.
• Following our inspection in October 2022, we found that the practice had failed to act on previous risks identified through risk assessments and infection, prevention and control audits. At this inspection, we found that the practice had completed the necessary risk assessments we would expect to see, and devised action plans in response to any concerns identified. We saw evidence that the practice had acted on issues identified through such risk assessments and audits and had a clear plan in place for addressing all concerns noted.
• An appropriate range of in-date emergency medicines were available, although their co-location across two clinical rooms would present access issues if items needed to be sourced in the event of an emergency and both clinical rooms were in use.
• Not all staff had completed the correct level of safeguarding training applicable to their roles.
• We saw evidence of comprehensive meeting minutes, with safeguarding and significant events / complaints discussed as a standard agenda item. However, on the complaints log submitted, it was not always clear what learning needs had arisen as a result.
• An informal arrangement was in place to provide clinical oversight of non-medical prescribers. However, there was no formalised process in place for the management of such prescribing.
• Staff interviewed were all able to describe in detail how significant events are recorded and managed, and how learning is cascaded and shared.
• All staff spoken with spoke positively about the work environment and stated they felt supported in their day-to-day duties. Staff were aware of their additional roles and could clearly state what their responsibilities were.
• The practice had implemented an allotment initiative to promote social inclusion and mental well-being. The practice had taken account of patients’ holistic needs and recognised the importance of how patients’ mental well-being can positively impact their physical state.
• Patients report that the practice is caring and go above and beyond for patients. This was further supported by observing both clinical and non-clinical staff interacting positively with patients throughout the day.

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

• Continue to monitor and take action to improve cervical screening and child immunisation uptake rates.
• Take action so that all staff have up-to-date training applicable to their role.
• Introduce a formalised process for managing non-medical prescribing.
• Continue to action items in response to risk assessments and audits.
• Explicitly record and detail the learning needs which arise from complaints and significant events.
• Risk assess the placement and accessibility of their emergency medicines supplies.

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 Health Care