Background to this inspection
Updated
14 July 2021
Keats Surgery is a GP practice located in the London Borough of Enfield and is part of the NHS Enfield Clinical Commissioning Group (CCG). The practice provides care to approximately 5200 patients and the practice area population has a deprivation score of 3 out 10 (1 being the most deprived). Keats Surgery serves a higher than average number of elderly patients and cares for a diverse population (with approximately 49% of its patients from Black and minority ethnic backgrounds). The practice is located on the ground floor and offers step free access. Keats Surgery is located on a main road served by local bus and train services.
The practice holds a GMS (General Medical Services) contract with NHS England. This a contract between NHS England and general practices for delivering general medical services and is the most common form of GP contract.
The practice is registered with the Care Quality Commission to provide the following regulated activities: Diagnostic and screening procedures; Family planning; Maternity and midwifery services; Surgical procedures; Treatment of disease, disorder or injury; and Surgical procedures.
The practice team consists of one male and one female GP, two part time female practice nurses, two part time clinical pharmacists, one part time phlebotomist a practice manager and an administrative/reception team. The practice’s opening hours are 8:00am to 6:30pm on weekdays.
Extended hours appointments are available from a local GP Hub 6:30pm-8:00pm weekdays and 8:00am-8:00pm at weekends.
During the Covid 19 outbreak, CQC’s regulatory role and core purpose of keeping people safe has not changed and we have developed an Emergency Support Framework (ESF) that allows CQC to target support where it’s most needed. Keats Surgery underwent an ESF in June 2020 and was assessed as ‘managing’ overall but assessed as requiring support in terms of the extent to which people using the service were being protected from abuse, neglect and discrimination during the Covid 19 outbreak.
Updated
14 July 2021
We carried out an announced inspection at Keats Surgery on 27 May 2021. Overall, the practice is rated as Good.
Safe - Good
Effective - Good
Caring - Good
Responsive - Good
Well-led - Good
The Good ratings for Caring and Responsive are in respect of our previous inspection which took place on 16 December 2020.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Keats Surgery on our website at www.cqc.org.uk
Why we carried out this inspection
We had previously inspected the practice on 16 December 2020, when we rated it Good in respect of the Caring and Responsive questions but rated it as Requires Improvement in respect of the Safe, Effective And Well led key questions. We served a Requirement Notice for breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
This inspection took place to confirm that the necessary actions had been taken to address the breach of regulation.
How we carried out the inspection
Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account 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
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 Good overall and Good for the following population groups: Older people, People with long-term conditions, Working age people (including those recently retired and students), People whose circumstances may make them vulnerable, People experiencing poor mental health (including people with dementia). We have rated the practice as Requires Improvement for the Families, children and young people population group.
We found that:
- Action had been taken since our last inspection to identify and act on infection risks. We noted this activity had improved staff knowledge, raised standards and minimised infection risks.
- Action had been taken since our last inspection to improve arrangements for monitoring Warfarin and to ensure they did not place patients at elevated risk.
- Unverified practice data indicated that actions to improve childhood immunisations had had a positive impact. However, performance on some targets continued to be below World Health Organisation targets.
- Action had been taken since our last inspection such that appropriate governance arrangements were now in place to identify and act on risks. Governance arrangements supported the delivery of patient centred care and treatment.
- The practice had 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.
Whilst we found no breaches of regulations, the provider should:
- Continue to take action to improve childhood immunisations and cervical screening uptake rates.
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