Holbrooks Health Team

Updated 16 September 2022

Holbrooks Health Team is situated in a purpose-built health centre in the area of Holbrooks, Coventry. Information published by UK Health Security Agency (UKHSA) shows that deprivation within the practice population group is in the fourth decile (four of 10) with one being most deprived and 10 being least deprived. Approximately 12,270 patients are registered with the practice and the practices patients are mostly within working-aged groups. The practice is a member of a Federation called the Coventry & Rugby GP Alliance (CRGPA) and is situated within the Coventry and Warwickshire Integrated Care System (ICS).

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

The clinical team at the practice includes a mix of male and female GPs, comprising of two GP partners, two salaried GPs and two sessional GPs (long-term locum GPs). One of the GP partners was responsible for the operational management of the practice. They had taken on the management lead role, in addition to some clinical work as a GP at the practice, at the time of our inspection. The practice is a training practice for medical students and trainee GPs. There was one trainee GP in post at the time of our inspection. There are two physician associates, three clinical pharmacists and four nurses; including a nurse manager and a nurse associate. Patients can also access additional care through the ARR (additional role) positions at the practice, this includes two first contact physio’s and social prescribers employed by the practices Primary Care Network (PCN). The practice had a team of staff who covered reception, secretarial and administration duties.

The practice is open for appointments between 8am and 6.30pm Monday to Friday. Patients can access appointments on weekday evenings between 6.30pm and 9.30pm and on Saturday and Sunday mornings by contacting the extended access Hubs across Coventry, Rugby and Nuneaton. When the practice is closed patients are directed to the GP out of hours service which is accessed through the 111 service.

Updated 16 September 2022

We carried out an announced comprehensive inspection at Holbrooks Health Team on 16 and 18 August 2022. Overall, the practice is rated requires improvement.

Safe - Good

Effective - Good

Caring - Good

Responsive – Requires Improvement

Well-led – Requires Improvement

Following our previous comprehensive inspection on 18 August 2021, the practice was rated requires improvement overall. Specifically, the practice was rated as requires improvement for providing safe and effective care, and inadequate for providing well-led services.

The full report for this inspection can be found by selecting the ‘all reports’ link for Holbrooks Health Team on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up on breaches of regulations from the previous comprehensive inspection. In addition, as part of this inspection we revisited areas of concern identified at a recent unannounced focussed inspection which took place on 2 August 2022. Therefore, as part of this comprehensive inspection we inspected all five key questions: safe, effective, caring, responsive and well-led.

How we carried out the inspection/review

This was a two-day inspection which included:

• 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.
• A full site visit.
• Reviewing evidence from the provider.
• Speaking with staff whilst on site.

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 demonstrated progress in providing safe and effective care.
• We noted improvements in the practice’s management of patients with long term conditions.
• There was a process for monitoring patients’ health in relation to the use of high risk medicines.
• The practice had strengthened their system for recording and acting on safety alerts.
• At this inspection, leaders demonstrated that they had the skills to deliver high quality care. There were clear responsibilities, roles and systems of accountability in place.
• There was some evidence which demonstrated efforts to engage patients in programmes for childhood immunisations and cervical screening. However, data remained below local and national uptake rates.
• During our inspection we observed that staff dealt with patients with professionalism, dedication and a caring nature.

Although we found that the provider had addressed key areas identified on the inspection in August 2021 and there was evidence of compliance with the specific regulatory breaches previously issued, we identified other areas that required further improvement:

• Some of the practices processes for managing risks, issues and performance contained gaps and were not always effective.
• Although there was evidence of an open culture at the practice, staff we spoke with were not aware of who their Freedom to Speak up Guardian was.
• Engagement with the public and staff had not always been effective, this impacted on the practices efforts to sustain high quality and sustainable care.
• We noted a theme in patient feedback indicating that they were not always able to access services in a timely way. The practice was making continued efforts to address and improve this, but they were unable to demonstrate impact at the time of our inspection.

We found a breach of regulations. The provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition, the provider should:

• Continue with efforts to engage patients’ patients in programmes for childhood immunisations and cervical screening.
• Explore further ways of identifying and capturing patients who are carers so that they are supported where needed.
• Continue to engage in practice support and improvement projects.
• Expand on the formal clinical supervision in place for the wider clinical team.

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 Hospitals and Interim Chief Inspector of Primary Medical Services