The Hove Practice

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good (carried over from previous inspection)

Are services responsive? – Good (carried over from previous inspection)

Are services well-led? – Good

We previously carried out a comprehensive inspection of The Hove Practice on 23 and 24 November 2021. We identified breaches of regulation 12 (Safe care and treatment) and regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and issued requirement notices. The service was rated as requires improvement for providing safe services and well-led services, and good for providing effective, caring and responsive services. The service was rated as requires improvement overall.

We carried out this announced comprehensive inspection of The Hove Practice on 17 May 2023 under Section 60 of the Health and Social Care Act 2008. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. At this inspection we checked that the service was providing safe, effective and well-led services. Our ratings of good for caring and responsive services are carried over from the previous inspection.

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:

• Speaking with staff in person, on the telephone and using video conferencing.
• Requesting documentary evidence from the provider.
• A site visit.

We carried out an announced site visit to the service on 17 May 2023. Prior to our visit we requested documentary evidence electronically from the provider. We spoke to staff on the telephone and using video conferencing prior to our site visit.

The Hove Practice is an independent provider of a range of GP services, including consultation, chronic disease management, child and adult immunisations, cervical screening, travel vaccinations, well man and well woman screening and advice, sexual health advice and testing, home visits and health assessments.

The Hove Practice is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury; Diagnostic and screening procedures.

The service’s medical director is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

• There were safeguarding systems and processes to keep people safe. Safeguarding guidance and practices had been reviewed and updated since our previous inspection.
• There were robust processes in place for the induction, training and monitoring of staff, including highly supportive mentorship processes.
• There were comprehensive and well managed records to demonstrate that staff recruitment checks had been carried out in accordance with regulations for all staff.
• Arrangements for chaperoning were effectively managed.
• There were processes to assess the risk of, and prevent, detect and control the spread of infection.
• Staff immunisation status was effectively monitored, in line with current guidance, for all staff.
• There were effective governance and monitoring processes to ensure the safety of premises.
• Fire safety processes were in place and well documented, including staff participation in fire drills.
• Risks associated with Legionella had been reviewed since our last inspection and were appropriately managed.
• There were systems in place to ensure the proper and safe storage of medicines and vaccines requiring refrigeration.
• There were clear and highly effective governance and monitoring processes to provide assurance to leaders that systems were operating as intended.
• There was evidence of comprehensive clinical audit and regular monitoring of clinical decision making, to ensure consistency of approach.
• Clinical record keeping was clear, comprehensive and complete, and enhanced by the development of consultation templates.
• There were effective administrative processes in place to ensure patients had timely access to consultation and treatment.
• There was effective and open communication and information sharing amongst the small staff team. There were regular management and team meetings and staff felt motivated to contribute to driving improvement within the service.
• Staff were subject to regular review of their performance and felt well supported by managers.
• Written policies were comprehensive and provided appropriate guidance to staff.
• Service users were asked to provide feedback on the service they had received and there were high levels of patient satisfaction across the service.
• Complaints were managed appropriately.

We saw the following outstanding practice:

• GPs employed by the service on a sessional basis were subject to regular review and support via a robust mentorship process, led by the medical director. GPs told us the mentorship programme included one-to-one review of their clinical decision making and high levels of personal support, following every clinical session, for a 3-month period as part of their induction programme. This enabled care and treatment of individual patients to be reviewed and discussed in order to promote optimum treatment outcomes and consistency of approach and to share learning.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care