The Care Quality Commission
  • Doctor
  • GP practice

Newgate Medical Group

Overall: Good read more about inspection ratings

Newgate Street, Worksop, Nottinghamshire, S80 1HP (01909) 500266

Provided and run by:
Newgate Medical Group

All Inspections

18 December 2023

During an inspection looking at part of the service

We undertook a targeted assessment of the responsive key question at Newgate Medical Group. The rating for the responsive key question is Requires Improvement. As the other domains were not reviewed during this assessment, the rating of good will be carried forward from the previous inspection and the overall rating of the service will remain Good.

Safe – Not inspected, rating of Good carried forward from previous inspection

Effective - Not inspected, rating of Good carried forward from previous inspection

Caring - Not inspected, rating of Good carried forward from previous inspection

Responsive – Requires Improvement

Well-led - Not inspected, rating of Good carried forward from previous inspection

Following our previous inspection from August 2022, the practice was rated requires improvement for responsive. The practice was rated as good for safe, effective, caring and well-led.

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

Why we carried out this inspection

We carried out a targeted assessment of the responsive key question. Targeted assessments enable us to focus on certain key questions to explore particular aspects of care.

How we carried out the inspection/review

  • This assessment was carried out without a site visit
  • Conducting staff interviews using video conferencing.
  • Requesting evidence from the provider and reviewing the appointment system.

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 found that:

  • Patient satisfaction with accessing the practice by phone and their appointment system has been below local and national averages over several years. The practice had an action plan for improvement. This included a new appointments system and updated telephone system. Early feedback suggested that this was improving access to services.
  • Complaints were satisfactorily handled in a timely way.

Whilst we found no breaches of regulations, the provider should:

  • Continue to review and improve patient satisfaction with access by phone and appointment availability.

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 Health Care

01 and 03 August 2022

During a routine inspection

We carried out an announced inspection at Newgate Medical Group between 1 and 3 August 2022. Overall, the practice is rated as good.

Safe - good

Effective - good

Caring - good

Responsive - requires improvement

Well-led - good

At the focused inspection on 24 July 2019, the practice was rated requires improvement overall and for the effective and well-led key questions, and rated good for the responsive key question. We did not inspect the safe and caring key questions during that inspection.

Following our previous inspection on 14 and 16 September 2021, the practice was rated requires improvement overall and for the safe, effective and responsive key questions and rated good for the caring and well-led key questions.

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

Why we carried out this inspection

We carried out this comprehensive inspection to follow up the breach of regulation from the previous inspection.

How we carried out the inspection/review

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 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 found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice recognised the importance of their Patient Participation Group and acted on their suggestions.
  • The practice had a complaints policy and was open, honest and transparent when dealing with concerns and complaints.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care. We found the previous areas of concern had mostly been addressed and systems had improved.

Whilst we found no breaches of regulations, the provider should:

  • Take further steps to improve telephone access to the practice for patients.
  • Apply to add the regulated activity of maternity and midwifery services to their registration with the CQC. (The provider submitted an application on 3 August 2022 which awaits processing.)
  • Continue to monitor and regularly review the validity of Patient Group Directions.
  • Continue to encourage patient uptake in cervical cancer screening and childhood immunisations.
  • Continue to closely monitor and review the processes for managing patient correspondence.
  • Fully implement the renewal programme for the existing premises.

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

14-16 September 2021

During a routine inspection

We carried out an announced inspection at Newgate Medical Group between 14 and 16 September 2021. Overall, the practice is rated as requires improvement.

Safe - requires improvement

Effective - requires improvement

Caring - good

Responsive - requires improvement

Well-led - good

Following our previous focused inspection on 24 July 2019, the practice was rated requires improvement overall and for the effective and well-led key questions, and rated good for the responsive key question. We did not inspect the safe and caring key questions during that inspection.

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

Why we carried out this inspection

This inspection was a comprehensive inspection to follow up on previous breaches of regulation.

How we carried out the inspection/review

Throughout the pandemic, CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using video conferencing
  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider
  • Reviewing patient records to identify issues and clarify actions taken by the provider
  • Requesting evidence from the provider
  • A site visit
  • Conducting an electronic staff questionnaire

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 overall and for all population groups.

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centred care.

However:

  • Not all staff had completed safeguarding training to appropriate levels for their role.
  • The practice’s systems for the appropriate and safe use of medicines, including medicines optimisation, required review.
  • The practice’s process for management of medicine safety alerts required review.
  • The practice was not meeting its target for childhood immunisation rates or cervical smear uptake.
  • Telephone access and appointment booking processes required further improvement.

We found several areas of outstanding practice:

  • The provider had assigned a dedicated GP to provide weekly cover at a large local school, which allowed children and young people to receive care, treatment and medical advice whilst at school.
  • The practice employed reception staff who could speak other languages commonly spoken by the local community. This allowed patients to communicate directly with the practice in their own language without the need of an interpreter or translator.
  • The practice had developed strong working relationships with several voluntary organisations and charities to allow patients, their families and their carers to receive dedicated help, advice and support.
  • The practice participated in several local and national pilots, including a national diabetes reversal pilot and a national weight management pilot.

We found one breach of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.

Although not a breach of regulations, the provider should:

  • Improve telephone access to the practice for patients.
  • Implement a robust system for the rechecking of staff professional registrations.
  • Improve the management of the disposal of sharps bins.
  • Improve childhood immunisation and cervical screening rates.
  • Implement a robust system for alerting Public Health England of any notifiable diseases.
  • Improve systems to identify carers.

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

24 July 2019

During an inspection looking at part of the service

We carried out an announced focused inspection at Newgate Medical Group on 24 July 2019 as part of our inspection programme.

We decided to undertake an inspection of this service following our annual review of the information available to us. This inspection looked at the following key questions:

  • Are services effective?
  • Are services responsive?
  • Are services well led?

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 overall.

We rated the practice as requires improvement for providing effective services because:

  • The practice was unable to show that clinical staff had the skills, knowledge and experience to carry out their roles due to lack of records.
  • Some performance data was below local and national averages.

We rated the practice as requires improvement for providing well-led services because:

  • The overall governance arrangements were not always effective due to lack of management oversight of recruitment and clinical staff training.
  • The practice did not have clear and effective processes for managing risks relating to recruitment.

We 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.

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

We saw several areas of outstanding practice:

  • Diabetes Care  - The lead nurse had experience as a lecturer in the diabetic programme for people with type 2 diabetes and offered borderline diabetics one-hour educational sessions in the practice. The health care assistant (HCA) provided home visits one day per week to complete health checks and completed ECGs and flu vaccinations during these visits. The practice had identified that patients' foot pulses were no longer recorded by community staff and the HCA was now completing this task for diabetic patients during the home visits.

  • Mental health  - The practice had identified the need for teenage mental health counselling and had developed a service to support this. They had employed two counsellors one who worked in practice and one who worked in a local school. An audit showed a progressive reduction in referral to secondary care services and an increase in acceptance of referrals made to these services showing evidence of more appropriate referrals.

  • Communication and meeting patients needs - The practice patient population was 8% Polish. The practice had employed reception staff who could speak Polish to improve communication with these patients. The practice had obtained a wide variety of easy read information leaflets and communication aids including aids to assist clinicians in consultations and reception staff. They had a dedicated member of staff who supported patients with learning disabilities and their carers to access the service which had enabled them to build a good knowledge of each patient’s individual needs. Annual reviews were arranged to meet these patients’ needs to ensure engagement with the process. For example, GPs visiting day care facilities.

The areas where the provider must make improvements are:

  • Ensure persons employed in the provision of the regulated activity receive the appropriate training and professional development necessary to enable them to carry out the duties.
  • Ensure specified information is available regarding each person employed.

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

The areas where the provider should make improvements are:

  • Review and improve blood pressure monitoring for patients with hypertension.
  • Review and improve uptake for childhood immunisations for children aged 2 years.

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

17 March 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Newgate Medical Group on 17 March 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for all the population groups.

Our key findings across all the areas we inspected 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.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and 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.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • 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.

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

Importantly the provider should.

  • Adhere to their recruitment policy when recruiting clinical and non clinical staff.
  • Ensure all clinical staff are aware of the Mental Capacity Act 2005, the Children Acts 1989 and 2004 and their duties in fulfilling it.
  • Ensure all clinical staff should have a clear understanding of Gillick competencies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice