The Garden City Practice

We carried out an announced comprehensive inspection at The Garden City Practice on 15 September 2022. Overall, the practice is rated as Requires Improvement.

Safe - Requires Improvement

Effective - Requires Improvement

Caring - Good

Responsive - Good

Well-led - Requires Improvement

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

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities.

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 the practice as Requires Improvement for providing safe services because:

• The practice’s systems and processes did not always keep people safe and safeguarded from harm.
• Risk assessments were not always supported with a clear record of actions taken.
• The practice’s systems for the appropriate and safe use of medicines, including medication reviews required improvement.
• Improvements were needed to the practice’s system for recording and acting on safety alerts.

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

• Patients' needs were assessed, but care and treatment were not always delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools.
• Improvements in performance related to cervical screening were required.
• Staff did not always have the training and skills to provide care.

We have rated the practice as Good for providing caring services because:

• Staff treated patients with kindness, respect and compassion. Feedback from patients was positive about the way staff treated people.
• National GP Patient survey results were in line with local and England averages.

We have rated the practice as Good for providing responsive services because:

• The practice organised and delivered services to meet patients’ needs.
• Patients could access care and treatment in a timely way.

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

• The practice had a vision and strategy that required strengthening to provide high quality sustainable care.
• Governance structures were not always in place. We found gaps for managing risks, issues and performance.
• Systems and processes for learning, continuous quality improvement and innovation, required strengthening.

We found one breach of regulations. The provider must:

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

(Please see the specific details on action required at the end of this report)

In addition, the provider should:

• Review and strengthen the medication review processes.
• Continue to embed Duty of Candour processes.
• Improve cervical cancer screening uptake in line with national targets.
• Continue to develop telephone systems to meet patient demand.
• Embed and ensure staff understand the vision, values and strategy.
• Develop staff access to an external Freedom to Speak Up Guardian for the practice.

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