Background to this inspection
Updated
15 January 2021
The Grange Surgery is located in Petersfield, Hampshire.
The practice area covers the town of Petersfield and the neighbouring rural villages. The building premises, a grade II listed building, are leased from a private landlord.
The Grange Surgery is located at:
The Causeway
Petersfield
Hampshire
GU13 4JR
The local clinical commissioning group (CCG) is the South Eastern Hampshire CCG. The Grange Surgery is registered with the Care Quality Commission to provide the following regulated activities:
• treatment of disease, disorder or injury
• diagnostic and screening procedures
• maternity and midwifery services
• surgical procedures
• family planning
The practice has approximately 7,612 registered patients.
The Grange Surgery has two GP partners and three salaried GPs. There are three practice nurses and two health care assistants. The practice also employs a practice manager, and a team of reception and administration staff. The practice is a training practice for doctors training to be GPs. At the time of inspection there was one GP registrar and one junior doctor in training attached to the practice. There are higher than average number of patients under the age of 18 when compared with national and local averages. There is a higher proportion of patients over the age of 65, when compared with the national average, however, this is lower than the clinical commissioning group local average. There is a higher proportion of the patient population in paid work or full-time education.
Information published by Public Health England, rates the level of deprivation within the practice population group as nine, on a scale of one to 10. Level 10 represents the lowest levels of deprivation and level one the highest.
Life expectancy is higher than average for females (86 years compared with the CCG average of 84 and the national average of 84). Life expectancy for males is the same as the CCG average of 80 years compared with the national average of 79 years.
The practice is open Monday to Friday, 8am to 6.30pm. Extended hours appointments are available on Mondays until 7pm and on Fridays from 7.30am for both pre-bookable and same day appointments. Opening times information is provided on the practice leaflet and on the surgery website.
Out of hours services can be accessed via the NHS 111 service.
More information in relation to the practice can be found on the practice website.
Updated
15 January 2021
We carried out an announced comprehensive inspection at The Grange Surgery on 1 December 2020 to review the actions taken by the practice to improve the quality of care provided since the previous inspection in October 2019. We rated this service as Good overall.
At the previous inspection published on 30 December 2019, the practice was rated as inadequate overall with a rating of inadequate for providing safe and well led services. The practice was rated as good for providing effective, caring and responsive services. As a result of the concerns identified, we issued a warning notice for breach of Regulation 17 Good Governance and a requirement notice for Regulation 19 Fit and Proper Persons employed. The practice was placed into special measures. We carried out an announced follow up inspection on 15 January 2020 and found that the practice had met the legal requirements in relation to the warning notice.
In light of the Covid-19 pandemic, CQC has looked at ways to fulfil our regulatory obligations, respond to risk and reduce the burden placed on practices by minimising the time spent on site in the service, during the pandemic, when compared to a traditional inspection. Due to this, we based our judgement of the quality of care at this service on a combination of:
- information the practice sent to us before the inspection
- remote staff interviews between 19 November and 24 November 2020
- 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. We have rated the practice as good for providing safe, effective, caring, responsive and well led services and for the following population groups: older people; people with long-term conditions; families children and young people; people whose circumstances may make them vulnerable and people experiencing poor mental health (including dementia).
We found that:
- Risk assessments had been carried out and actions had been completed in a timely manner to keep patients and staff safe.
- Infection control audits had been completed in line with practice policy and actions to mitigate risk had been carried out.
- The practice had implemented a log of safety alerts and updated this accordingly to ensure actions had been completed.
- The practice had introduced a new system to record significant events and complaints which were discussed at practice meetings and outcomes and learning identified was recorded and shared with staff.
- The practice made improvements to its recruitment system to ensure newly employed staff had a disclosure and barring system (DBS) check or appropriate risk assessment in place.
- The practice had implemented a new process to ensure that all clinical staff registration was monitored and up to date.
- Staff vaccinations were maintained in line with Public Health England guidance.
- The practice had made improvements to its oversight of monitoring of staff training.
- The practice had reviewed and updated their systems and processes to ensure compliance with practice policies and national guidance.
- Practice policies were fully embedded, appropriately reviewed and accessible to staff.
- 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 areas where the provider should make improvements are:
- Continue to monitor the system for recording fridge temperatures to ensure this is carried out on a daily basis.
- Continue to review and address areas of improvement identified through staff feedback.
- Continue to improve uptake of cervical screening to meet the 80% national target.
I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.
Details of our findings and the evidence supporting our ratings are set out in the evidence table.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care