Horsmans Place Partnership Also known as Horsmans Place Surgery

Updated 2 June 2023

Horsmans Place Partnership is located at Instone Road, Dartford, Kent, DA1 2JP

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning, treatment of disease, disorder or injury and surgical procedures

The practice is situated within the Kent and Medway Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of about 9370. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices: Dartford Central Primary Care Network (PCN)

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the fifth lowest decile (five of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 85.6% White, 6.8% Asian, 4.3% Black, 2.4% Mixed, and 0.9% Other.

There is a team of 4 GP partners and 2 GP registrars. The practice has a team of 3 nurses who provide nurse led clinics for long-term conditions. The nursing team are supported by a health care assistant (HCA). The practice has 2 clinical pharmacists who carry out medicine reviews and answer medicine queries. The GPs are supported at the practice by a team of reception and administration staff. The practice currently has an interim practice manager in post to provide managerial oversight.

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

Extended access is provided locally by the PCN where late evening and weekend appointments are available. Out of hours services are provided via NHS 111.

Updated 2 June 2023

We carried out an announced comprehensive inspection at Horsmans Place Partnership on 6 April 2023. Overall, the practice is rated as good.

Safe - good

Effective – good

Caring - good

Responsive - requires improvement

Well-led - good

Following our previous inspection on 17 May 2022 the practice was rated Inadequate overall and for providing safe and well-led services, rated Requires Improvement for providing effective and responsive services, and rated Good for providing caring services. The practice was rated Inadequate overall and placed into special measures as a result of this inspection. The provider was issued Warning Notices for breaches of Regulation 12 - Safe care and treatment and Regulation 17 - Good governance.

We carried out an announced follow up inspection on 20 October 2022, to check progress against the requirements of the Warning Notices issued and found full compliance had been achieved. However, breaches of Regulation 12 – Safe care and treatment were identified. The practice was not rated as a result of this inspection and the rating of Inadequate awarded to the practice following our full comprehensive inspection on 17 May 2022 remained unchanged.

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

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from our previous inspection.

This was a comprehensive inspection to review the following domains:

• Safe
• Effective
• Caring
• Responsive
• Well-led

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.

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:

• The practice had clear systems, practices and processes to keep people safe and safeguarded from abuse.
• Patients’ needs were assessed, and care and treatment was delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools.
• The provider carried out quality improvement activity.
• Staff worked together and with other organisations to deliver effective care and treatment.
• Staff helped patients to be involved in decisions about care and treatment.
• Patients experienced difficulty accessing the practice by telephone.
• The practice had taken action to address the issues regarding access. However, the provider had not yet collected patient feedback to demonstrate the effectiveness of the action taken.
• Leaders had taken action to ensure the quality, safety and performance of the service.
• There were clear systems to support good governance.
• The practice had processes for managing issues, risks and performance.

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

• Continue with their action plans to; ensure all documents and tasks are managed in a timely way and marked as complete when actioned; reduce prescriptions of benzodiazepines and Z drugs; manage all patients with asthma in line with best practice guidance; monitor and improve the uptake of childhood immunisations and cervical cancer screening; monitor the actions taken to improve access, including the use of patient feedback exercises.
• Take action to ensure the temperature of water outlets are within recommended ranges.
• Provide up-to-date information regarding the patient participation group on the practice website.
• Maintain the changes made to ensure staff areas are not accessible to patients or visitors.
• Take effective action to identify a larger proportion of carers in the patient list.

This service was placed in special measures following our inspection on 17 May 2022. The practice has made significant improvements and is now rated Good overall and for providing safe, effective, caring and well-led services.The practice is rated Requires Improvement for providing responsive services. I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service. The service will be kept under review and will be inspected within 12 months to ensure improvements are sustained.

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.