30 October 2019
During an inspection looking at part of the service
We carried out an announced focused inspection at Church Road Surgery on 30 October 2019, following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a change to the quality of care provided since the last inspection.
This inspection focused on the following key questions:
•Effective
•Well-led
Because of the assurance received from our review of information we carried forward the ratings for the following key questions:
•Safe
•Caring
•Responsive
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 Good overall.
We rated the practice as requires improvement for population group Families, children and young people because:
•The uptake of childhood immunisation was below the national target.
We rated the practice as good for providing effective and well led services because:
•The practice reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
Whilst we found no breaches of regulations, the provider should:
•Continue to promote and explore ways to improve the uptake of cancer screening and childhood immunisation.
•Review the systems to manage risk to ensure potential risks are assessed and managed effectively and regularly reviewed. For example, systems for monitoring staff training and consent, access to polices in the event of IT failure and the arrangements for the checking of equipment.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care