Background to this inspection
Updated
6 February 2019
Boundary House Surgery is situated in Edmonton, North London within the NHS Enfield Clinical Commissioning Group (CCG). The practice holds a Primary Medical Services contract (an agreement between NHS England and general practices for delivering personal medical services). The practice provides a full range of enhanced services including adult and child immunisations, facilitating timely diagnosis and support for people with dementia, and minor surgery.
The practice is registered with the Care Quality Commission to carry on the regulated activities of Maternity and midwifery services, Treatment of disease, disorder or injury, Family planning, Surgical procedures and Diagnostic and screening procedures.
The practice had a patient list of around 4,900 at the time of our inspection. The staff team at the practice consists of two GP partners (female), two long term GP locums and one practice manager. There are two practice nurses (female) and five administrative staff. There is a mixture of full-time and part-time staff. The practice is a training practice for practice nurses and has one qualified general nurse in specialist training.
The practice’s reception is open between 8.00am and 6.30pm Monday to Friday.
The practice had a slightly lower percentage than the national average of people with a long-standing health conditions (51% compared to a national average of 53%). The average male and female life expectancy for the Clinical Commissioning Group area was higher than the national average for males and in line with the national average for females.
Updated
6 February 2019
We carried out an announced comprehensive inspection at Boundary House Surgery on 9 December 2015. The overall rating for the practice was requires improvement.
We carried out an announced follow-up inspection at Boundary House Surgery on 21 September 2016. The practice was rated as inadequate for providing safe, effective and well-led services and was rated inadequate overall and urgent enforcement action was taken to
suspend the provider of Boundary House Surgery from providing primary medical services under Section 31 of the Health and Social Care Act 2008 ("the Act”) for a period of six months to protect patients. The practice was also placed in special measures for a period of six months.
We carried out a further announced comprehensive inspection on 21 March 2017. The practice was rated as good for providing caring services, requires improvement for providing safe and responsive services but continued to be rated inadequate for providing effective and well-led services and was rated inadequate overall. The practice was issued with a requirement notice and remained in special measures as it had not made sufficient improvements to achieve compliance with the regulations.
We carried out a further announced comprehensive inspection on 29 November 2017 following the extended period of special measures to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 21 March 2017. The practice was rated requires improvement overall and for providing effective and responsive services but was not in breach of regulations. Although we found improvements had been made, we were not assured the actions taken were sustainable. The practice was rated good for providing safe, caring and well-led services and taken out of special measures.
We carried out an announced comprehensive inspection at Boundary House Surgery on 29 November 2018 to confirm whether the improvements put in place at the time of the November 2017 inspection had been maintained.
The reports from the December 2015, September 2016, March 2017 and November 2017 inspections can be found by selecting the ‘Reports’ link for Boundary House Surgery on our website at http://www.cqc.org.uk/location/1-583321983.
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 good overall and good for all population groups.
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
- The practice offered extended hours which included later appointments on Tuesday and Wednesday evenings.
- The practice was actively engaged with the local community and worked closely with the Patient Participation Group on projects to improve health outcomes and combat social isolation.
Whilst we found no breaches of regulations, the provider should:
- Continue to monitor patient satisfaction and consider taking further actions to bring about improvements so that practice performance is in line with national survey results.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice