We carried out an announced comprehensive inspection at Lakeside Healthcare at Rushden, formally known as Rushden Medical Centre on 29 November 2018 as part of our inspection programme.

Our judgement of the quality of care at this service is based 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.

I have rated this practice as requires improvement overall.

This means that:

• People were protected from avoidable harm and abuse and that legal requirements were met.
• The prescribing of high risk medicines, warfarin and Ace inhibitors did not keep people safe.
• Patients had good outcomes because they received effective care and treatment that met their needs.
• Patients were supported, treated with dignity and respect and were involved as partners in their care.
• People’s needs were met by the way in which services were organised and delivered.
• The leadership, governance and culture of the practice did not always promote the delivery of high quality person-centred care.

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

• The practice did not always act on appropriate and accurate information.

We identified an area of outstanding practice:

• Lakeside Healthcare Partnership, as a provider, had their own designated safeguarding team who were employed within the partnership from Monday to Friday to cover all aspects of the safeguarding processes to protect both children and adults. The team covered all aspects of the safeguarding role with a view that this increased staff’s knowledge of at risk patients and ensured a level of continuity. The members of the team were easily contactable during working hours via telephone or the task system on the clinical record system. Staff told us, and we found evidence, that as dealing with safeguarding concerns was the only role of the dedicated team that this enabled them to produce much more detailed safeguarding referrals and child protection reports.

The areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition, the provider should:

• Review the safeguarding process to ensure all staff have sight of safeguarding indictors on the clinical system.
• Review the system for recording and documenting actions in respect of significant events and complaints to ensure that actions and learning is clear.
• Review the staff training requirements for health care assistants.
• Take steps to ensure that older MHRA alerts are re-visited and reviewed.
• Review the availability of extended hours appointments.
• Review the process to improve the identification and recording of carers.
• Review their QOF reporting process to ensure that exceptions are appropriate.

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

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice