Archived: Hadley Health Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hadley Health Centre on 10 July 2015. Overall the practice is rated as inadequate.

Specifically, we found the practice inadequate for providing safe, effective, and well led services. It required improvement in providing a responsive and caring service. There were aspects of practice which were inadequate and related to all population groups, it was also therefore inadequate for providing services for the all population groups.

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

• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example appropriate recruitment checks on staff had not been undertaken prior to their employment and no recruitment records were held by the practice.

• Staff were clear about reporting incidents, near misses and concerns but the systems in place were not robust and there was no evidence of learning and communication with staff.

• There was insufficient assurance to demonstrate people received effective care and treatment.

• Patients were positive about their interactions with staff and said they were treated with compassion and dignity.

• There was a leadership structure with named members of staff in lead roles, but limited formal governance arrangements.

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

Importantly, the provider must:

• Ensure recruitment arrangements include all necessary employment checks and that appropriate records are held for all staff. Ensure there is a robust recruitment policy in place for staff to follow.
• Put systems in place to ensure all clinicians are kept up to date with national guidance and guidelines.
• Ensure audits of practice are undertaken, including completed clinical audit cycles.
• Ensure there are formal governance arrangements in place including systems for assessing and monitoring risks and the quality of the service provision.
• Ensure staff have appropriate policies and guidance to carry out their roles in a safe and effective manner which are reflective of the requirements of the practice.
• Ensure the availability of medicines required in the event of an emergency are available such as oxygen. Oxygen is considered essential in dealing with certain medical emergencies. Ensure where there is an absence of emergency medicines, such as those used to treat suspected meningitis and seizures that an appropriate risk assessment is carried out to identify why they are not suitable for the practice to stock, and how this is kept under review.
• Complete a review of staffing sufficiency to ensure there are sufficient numbers of suitably qualified skilled and experienced staff.
• Complete an Infection Prevention and Control audit as the last audit took place in 2012.
• Ensure that all products subject to Control of Substances Hazardous to Health (COSHH) requirements are stored appropriately.

In addition the provider should:

• Consider equality and diversity training for all staff.
• Consider a practice website to improve patient access to information regarding the services it provides.
• Set up a patient participation group to assist the practice in gaining meaningful patient feedback.
• Ensure there is leadership capacity to deliver all improvements.

On the basis of the ratings given to this practice at this inspection I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care we will take steps to cancel its registration with CQC.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice