The Care Quality Commission
  • Doctor
  • GP practice

Hurley Clinic

Overall: Requires improvement read more about inspection ratings

Ebenezer House, Kennington Lane, London, SE11 4HJ (020) 7735 7918

Provided and run by:
Hurley Clinic Partnership

All Inspections

13 and 14 September 2023

During a routine inspection

We carried out an announced comprehensive inspection at Hurley Clinic on 13 and 14 September 2023. Overall, the practice is rated as requires improvement.

Safe - requires improvement

Effective - requires improvement

Caring - good

Responsive – requires improvement

Well-led - requires improvement

Following our previous inspection on 19 November 2014 the practice was rated good overall and for providing safe, effective, caring and well-led services but requires improvement for providing responsive services. We carried out a focused follow-up inspection on 16 June 2016 and found improvements had been made. Following the 2016 inspection we rated the practice as good for providing responsive services.

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

Why we carried out this inspection

This inspection was a comprehensive inspection to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included :

  • Conducting staff interviews using video conferencing.
  • 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.
  • 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 Requires Improvement.

We have rated this practice as Requires Improvement for providing safe services because:

  • The provider had not acted in relation to risks identified in legionella risk assessments.
  • Staff did not always have the appropriate authorisations to administer medicines via the correct use of Patient Group Directions.
  • All medicines were not always reviewed during medicine reviews.
  • Safety alerts were not always actioned in line with national guidance.

We have rated this practice as Requires Improvement for providing effective services because:

  • Patients with long-term conditions were not always monitored in line with best practice guidance.
  • Improvements were needed to the uptake rates of childhood immunisations and cervical cancer screening.

We have rated this practice as Requires Improvement for providing responsive services because:

  • The provider had attempted to improve patient access, however the impact of these changes was not yet reflected in patient feedback.

We have rated this practice as Requires Improvement for providing well-led services because:

  • The practice had not identified and managed all risks relating to the management of; safety alerts; patients with long-term conditions; medicine reviews; access to appointments; and legionella management.

We found that:

  • The practice learned and made improvements when things went wrong.
  • The practice had a comprehensive programme of quality improvement activity.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • Complaints were listened and responded to and used to improve the quality of care.

We found two breaches of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • Take steps to ensure staff immunisations are maintained in line with current UK Health and Security Agency guidance.

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 Health Care

16 June 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the practice on 19 November 2014. Breaches of legal requirements were found. After the comprehensive inspection, the practice did not submit their action plan. However we were sent the action plan in June 2016 ahead of the focussed inspection. The practice wrote to us to say what they would do to meet the legal requirements in relation to the breaches of regulation 10 (1)(2)(b)(i) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this desk-based focussed inspection on 16 June 2016 to check that they had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements and also where additional improvements have been made following the initial inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for the Hurley Clinic on our website at www.cqc.org.uk.

Overall the practice was rated as Good. Specifically, following the focussed inspection we found the practice to be good for providing responsive services.

Our key findings across all the areas we inspected were as follows:

  • The practice had implemented some changes to the appointment system to improve access to appointments for patients.
  • Data from the national GP patient survey indicated on-going difficulties with getting through to the practice by telephone and difficulty booking appointments.
  • The practice had improved the communication system in the waiting area for patients.
  • The practice had gathered feedback from patients via their annual survey and complaints which indicated that there was some improvement in satisfaction with appointments.
  • The practice had systems in place to improve the quality of the services provided by gathering the views of service users. There had been evidence of engagement with the Patient Participation Group (PPG) and a patient satisfaction survey had been undertaken.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

19 November 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hurley Clinic on 19 November 2014. We visited the practice site at Ebenezer House, Kennington Lane, SE11 4HJ.

Overall the practice is rated as good. Specifically, we found the practice to be good at providing safe, effective, caring and well-led services. We found the practice to require improvement for providing a responsive service. We found the practice to be good for providing services to the population groups of older people, people with long term conditions, working age people (including those recently retired and students), people whose circumstances may make them vulnerable, families, children and young people, and people experiencing poor mental health (including people with dementia).

Our key findings were as follows

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
  • The practice used proactive methods to improve patient outcomes, working in multidisciplinary teams to share best practice.
  • The practice had strong governance arrangements in place.

We saw one particular area of outstanding practice. The practice were engaged with their PPG and provided them opportunities to input into decisions about the running of the practice. For example, members of the PPG had been an active part of the recruitment process of new GPs into the practice, and had been satisfied with the decisions made about the new GPs recruited.

However, there were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

  • ensure it takes action to address the difficulties patients have with the appointments system

In addition the provider should:

  • ensure mandatory staff training is up to date, particularly fire safety training.
  • ensure a suitable and clear means of communication with patients to go in for their appointments is in place in the practice waiting area.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice