The Care Quality Commission
  • Doctor
  • GP practice

Archived: Silver End Surgery

Overall: Good read more about inspection ratings

Broadway, Silver End, Witham, Essex, CM8 3RQ

Provided and run by:
HCRG Care Services Ltd

Important: The provider of this service changed. See old profile
Important: The provider of this service changed. See new profile

All Inspections

16/04/2019

During a routine inspection

We carried out an announced comprehensive inspection at Silver End Surgery on 16 April 2019 as part of our inspection programme.

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 previously carried out an announced comprehensive inspection at Silver End Surgery on 17 January 2018 when the overall rating for the service was requires improvement. We found the practice required improvement for providing safe, responsive and well led services. We issued a requirement notice for regulation17, good governance, to ensure the practice made appropriate improvements.

This inspection was an announced comprehensive inspection carried out on 16 April 2019, to confirm that the service had carried out their plan to meet the legal requirements, in relation to the breaches in regulations that we identified in our previous inspections

We rated the practice as requires improvement for responsive services because:

  • The practice planned and delivered services to respond to their registered population needs. However, the low satisfaction rates in the GP national survey were lower than the previous year in certain areas.

These areas affected all population groups in responsive, so we rated all population groups as requires improvement.

We rated the practice as good for providing safe, effective, caring and well-led services because:

  • Significant events were identified and investigated effectively. Learning was shared with staff through meetings and communications to mitigate the risk of reoccurrence.
  • Clear systems and processes were in place to keep patients safeguarded from abuse. Staff were able to identify the safeguarding lead and had received the appropriate training.
  • Systems were in place to manage health and safety risks.
  • Effective and appropriate standards of cleanliness and hygiene were being met. An annual audit and regular monitoring had been carried out.
  • Patients received effective care and treatment that was monitored to meet their needs.
  • Staff dealt with patients through kindness, and respected and involved them in decisions about their care.
  • The practice had identified patients that were carers to ensure they had access to the care and support they needed.
  • The corporate system to manage, investigate and analyse complaints was effective, timely, identified learning was cascaded to staff. This showed improvements were made and included a system to identify any trends and themes requiring action.
  • The practice had effective clinical oversight, to ensure care and treatment was well-led.
  • The GPs had the skills to deliver high-quality, sustainable care.
  • Staff told us they felt supported, valued and that their opinions were well regarded.

The areas where the provider should make improvements are:

  • Continue to improve levels of patient satisfaction in relation to, how easy to access the practice by telephone, and their experience of making an appointment.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

17 January 2018

During a routine inspection

Letter from the Chief Inspector of General Practice

This practice is rated as requires improvement overall.

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Requires Improvement

Are services well-led? – Requires Improvement

As part of our inspection process, we also look at the quality of care for specific population groups.

The population groups are rated as:

Older People – Requires Improvement

People with long-term conditions – Requires Improvement

Families, children and young people – Requires Improvement

Working age people (including those retired and students – Requires Improvement

People whose circumstances may make them vulnerable – Requires Improvement

People experiencing poor mental health (including people with dementia) - Requires Improvement

We carried out an announced comprehensive inspection at Silver End Surgery on 17 January 2018 as part of our inspection programme.

At this inspection the key findings were as follows:

  • Staff could identify and respond appropriately to patients that developed deteriorating health or medical emergencies.

  • The practice had reliable systems for appropriate and safe storage of medicines.

  • The practice took steps to maintain the safety of the working environment.

  • We were not assured that the practice learned or shared action taken to improve safety when serious incidents or significant events should have been investigated.

  • Patients care treatment and support achieved positive outcomes because delivery was based on the best available evidence.

  • The practice monitored and reviewed the effectiveness and appropriateness of medical annual reviews. When identified reviews had not taken place, action was taken to contact patients.

  • Not all appropriate staff had undertaken Mental Capacity Act training.

  • Patients received coordinated care, were assisted to live healthier and gave consent when required. However, multi-disciplinary meetings were not taking place.

  • The practice had a process to follow up failed attendance of children’s appointments following a referral or an appointment to secondary care or for immunisation.

  • Patients were supported, treated with dignity and respect, and were involved as partners in their care.

  • The practice proactively identified patients that were carers and offered them extra support.

  • The importance of flexibility, informed choice and continuity of care was reflected in the practice.

  • Staff booking home visits were aware how to escalate patients describing urgent medical conditions that may require a more urgent response.

  • When patients raised complaints or concerns, the practice did not always consider their views, investigate them thoroughly or change practice to improve.

  • Leadership and governance required strengthening in some areas.

  • There was a corporate process to review key items such as the strategy, values, objectives, plans and governance framework; however, this was not being consistently applied at the practice.

  • Some audits had been carried out however, there was no programme for regular audits or other quality assurance for the service that would assess, monitor and improve the quality of the services provided.

  • The practice had responded to an area of low data in the national GP patient survey and were looking at ways of improving patient satisfaction.

The areas where the provider must make improvements as they are in breach of regulations are:

  • 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:

  • Ensure appropriate staff receive relevant training on the Mental Capacity Act.

  • Undertake multi-disciplinary meetings with other healthcare professionals and ensure record keeping is maintained.

  • Continue to monitor and improve patient satisfaction in relation to waiting times.

  • Implement a quality assurance programme that includes undertaking clinical audits.

  • Improve the cascading of information to staff from team meetings to ensure that staff are aware of issues affecting practice performance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice