The Care Quality Commission
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  • GP practice

Archived: The Practice Whitehawk Road

Overall: Requires improvement read more about inspection ratings

179 Whitehawk Road, Brighton, East Sussex, BN2 5FL (01273) 310333

Provided and run by:
Chilvers & McCrea Limited

All Inspections

13 April 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

The Practice Whitehawk Road was inspected in May 2015 where they were rated requires improvement in safe, effective and well-led services. They were rated as good in caring and responsive. As a result we carried out a further announced comprehensive inspection at The Practice Whitehawk Road on 13 April 2016. We found the practice to require improvement in safe, caring and well-led services. They are rated as good in effective and responsive services. Overall the practice is rated as requires improvement. .

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

  • Patients said they were treated with compassion, dignity and respect. However, results from the GP patient survey showed that not all patients felt listened to or involved in their care in relation to GP consultations.
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
  • Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks and monitoring of urgent referrals.
  • Data showed patient outcomes were comparable to the national average although there was high exception reporting in some areas. Although some audits had been carried out and there was some evidence that audits were driving improvements to patient outcomes there was no clear programme of continuous clinical audit.
  • There were some issues with availability of nursing appointments and there was no healthcare assistant in post so health checks were not being offered proactively unless a patient requested one.
  • The practice had not identified which of their patients were also carers although there was some information in the practice on support for carers.
  • There was no clear vision, strategy or business plan.
  • The practice had taken positive action following a previous inspection including ensuring that clinical equipment was cleaned and that medicines were stored securely. The practice had also ensured that staff, multi-disciplinary and safeguarding meetings were being held regularly.

The areas where the provider must make improvements are:

  • Ensure that employment checks are carried out on all staff prior to commencement in post.
  • Ensure that there is a centralised system in place to monitor the adoption of NICE guidance.
  • Ensure there is a system for monitoring the process of urgent referral so that the practice is assured that the referral has been processed and the patient seen.
  • Ensure that the practice engages with patients through the use of patient participation and patient surveys and that there is clear action taken to improve the patient experience, particularly in relation to GP consultations.
  • Ensure there is clear leadership and adequate staff to meet patient needs within the practice and that staff roles and responsibilities are clear during a period of change.

In addition the provider should:

  • Ensure that there is a programme of continuous clinical audit in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

06 May 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of The Practice Whitehawk Road on 6 May 2015. Overall the practice is rated as requires improvement.

Specifically, we found the practice to require improvement in being well-led and for providing safe and effective services. It was good for providing a caring and responsive service.

The Practice Whitehawk Road provides primary medical services to people living in the Whitehawk area of Brighton and Hove. At the time of our inspection there were approximately 3980 patients registered at the practice with three part time locum GPs, one of whom was a long term locum. In addition, a lead GP from another practice within the locality that was part of The Practice Group/ Chilvers and McCrea Ltd provided additional support and supervision to the locum GPs. The lead GP from another practice within the Group also helped run a regular substance misuse clinic at the practice. The practice was also supported by a nurse and a team of reception and administrative staff.

The inspection team spoke with staff and patients and reviewed policies and procedures. The practice understood the needs of the local population and engaged effectively with other services. There was a culture of openness and transparency within the practice and staff told us they felt supported. The practice was committed to providing high quality patient care and patients told us they felt the practice was caring and responsive to their needs.

Our key findings were as follows:

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • Risks to patients were assessed and well managed.
  • The practice had systems to keep patients safe including safeguarding procedures and means of sharing information in relation to patients who were vulnerable.
  • Infection control audits and cleaning schedules were in place and the practice was seen to be clean and tidy.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance.
  • Staff had received training appropriate to their roles, with the exception of chaperone training for administrative staff and training in the Mental Capacity Act 2005 for all staff. Any further training needs had been identified and planned.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • The practice had responded to concerns from patients about not being able to get appointments at a time that suited them and difficulties getting through to the practice by phone.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The practice had the appropriate equipment, medicines and procedures to manage foreseeable patient emergencies.

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

The areas where the provider must make improvements are;

  • Ensure that medicines are stored securely.
  • Ensure all staff have received training in the Mental Capacity Act 2005 and that all staff acting as chaperones have received formal training.
  • Ensure that plans are developed for a Patient Participation Group and that other ways are developed of gathering feedback from patients including hard to reach patients and groups.
  • Ensure that there are cleaning schedules for the clinical equipment kept in the treatment rooms and accurate, up to date records that these have been cleaned in line with the schedule.

The areas where the provider should make improvements are:

  • Develop plans to implement regular multidisciplinary meetings, particularly for patients on the palliative care register.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

12 September 2014

During an inspection in response to concerns

This inspection was carried out due to concerns being raised about the suitability and appropriateness of staffing in the practice. We spoke with the previous manager of the practice, three reception staff, a nurse and a locum GP. We also spoke with the area operational lead GP for the practice. We spoke with patients on the telephone following our inspection.

Patients spoke positively about the practice. They had no concerns about the staff or their treatment. Patients told us that it had been difficult to get appointments but when they did see a nurse or GP this was a positive experience.

We found that the provider did not have effective systems for safeguarding children and vulnerable adults . The practice did not have satisfactory recruitment practices and sufficient suitably skilled staff were not always available to meet the needs of patients and the practice.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. The name appears because they were still registered with CQC at the time.