Archived: Herstmonceux Integrated Health Centre

We carried out an announced inspection at Herstmonceux Integrated Health Centre on the 14th and 20th April 2022. Overall, the practice is rated as requires improvement.

Safe - Requires improvement

Effective - Requires improvement

Caring - Outstanding

Responsive - Good

Well-led - Requires improvement

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Herstmonceux Integrated Health Centre on our website at www.cqc.org.uk

Why we carried out this inspection.

We inspected the practice because it was newly registered as a partnership. This inspection was comprehensive and covered the safe, effective, caring, responsive and well led key questions.

How we carried out the inspection.

Throughout the pandemic CQC has continued to regulate and respond to risk. However, considering the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting evidence from the provider
• A short site visit
• A staff questionnaire

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 have rated this practice as requires improvement overall.

We found that:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
• Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, holistic and person-centre care.
• Feedback from patients about their care was consistently positive. The practice scored above average in all areas of the national GP patient survey.
• Patient views were actively sought and helped to shape the planning and development of services.
• The practice had close links with the community and was involved in several initiatives to reduce social isolation and improve people’s emotional and physical well-being.
• Staff felt supported by their managers and that their well-being was prioritised.

We rated the practice as requires improvement for providing safe services because:

• Blank prescription stationery was not handled securely or monitored in line with national guidance.
• The practice did not have effective processes for monitoring patients’ health in relation to the use of some medicines.
• Systems for ensuring safety alerts were acted on were not always effective.
• The practice had not taken enough steps to ensure appropriate antimicrobial use.
• Staff vaccination was not maintained in line with current national guidance relevant to their role.

We rated the practice as requires improvement for providing effective services because:

• Not all staff had received essential training, for example sepsis in primary care.
• There was limited evidence to show that new staff had completed an induction.
• The practice could not demonstrate how they assured the competence of staff employed in advanced clinical practice.
• The practice did not have effective processes for monitoring patients’ health in relation to some long-term conditions, for example patients with hypothyroidism.

We rated the practice as outstanding for providing caring services because:

• Feedback from patients and their representatives who used the service, was consistently positive about the way staff treated people. Patients felt that staff go ‘the extra mile’ and that their care and support exceeded their expectations.
• Patient’s emotional and social needs were as important as their physical needs.
• The practice had found innovative ways to enable people to manage their own health and well-being and was able to demonstrate reduced dependence on GP services as a result.

We rated the practice as good for providing responsive services. However, we identified timely patient access to services and appointments as an area of outstanding practice.

We rated the practice as requires improvement for providing well-led services because;

• Leaders lacked oversight of some processes and therefore failed to identify risks when those processes did not operate as intended.

We found three breaches of regulations. The provider must:

• Ensure safe care and treatment.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure staff receive appropriate support, training, professional development and supervision.

In addition, the provider should:

• Regularly review and maintain an up to date safeguarding register.
• Document risk assessments for the emergency medicines the practice had decided not to stock.
• Ensure that significant events are followed up to ensure actions have been completed.
• Keep a copy of proof of identity on staff files.
• Annually check and record the professional registration to ensure that it is current.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care