The Care Quality Commission
  • Doctor
  • GP practice

The New Surgery

Overall: Good read more about inspection ratings

128 Canterbury Road, Folkestone, Kent, CT19 5SR (01303) 243516

Provided and run by:
The New Surgery

All Inspections

During an assessment under our new approach

The practice was last inspected on 21 January 2023. Date of current assessment: 2 October to 16 October 2024. The New Surgery is an NHS GP practice located in Folkestone an area of high deprivation. There were approximately 10,300 people registered with the service at the time of our assessment. We conducted this assessment due to the previous rating of Requires Improvement. At this assessment, we found there was a strong focus on medicines optimisation.

The practice is open between 8.30am to 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided locally by the Primary Care Network (PCN), where late evening and weekend appointments are available. Out of hours services are provided by NHS 111. NHS 111 deals with urgent problems when GP surgeries are closed.

10 November 2022

During a routine inspection

We carried out an announced comprehensive inspection at The New Surgery on 10 November 2022. Overall, the practice is rated as good.

Safe - requires improvement

Effective - good

Caring – good

Responsive – good

Well-led - good

Following our previous inspection on 10 May 2016 the practice was rated good overall and for providing effective, caring, responsive and well-led services, but requires improvement for providing safe services. At a follow up inspection on 3 November 2016 the practice was rated good overall and for providing safe services.

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

Why we carried out this inspection

This inspection was a comprehensive inspection to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

How we carried out the inspection

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 short 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 have rated this practice as Good.

We found that:

  • The practice learned and made improvements when things went wrong.
  • Staff helped patients to live healthier lives.
  • Staff treated patients with kindness and respect and involved them in decisions about their care.
  • Complaints were listened and responded to and used to improve the quality of care.

We have rated this practice as Requires Improvement for providing safe services because:

  • Infection prevention and control audits were not fully completed.
  • There was a lack of action plans in relation to issues identified by infection prevention and control audits.
  • Improvements were needed to the practice’s systems for the appropriate and safe use of medicines, including medicines optimisation.
  • Safety alerts were not always managed in line with best practice guidance.
  • Some patients with long term conditions did not always receive the required monitoring and reviews in line with best practice guidance.

We found one breach of regulation. The provider must:

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

The areas where the provider should make improvements are:

  • Continue to improve cervical cancer screening uptake.
  • Continue to improve child immunisation uptake for children aged 1.
  • Monitor staff immunisations in line with current guidelines.

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

We have not revisited Drs Robertson-Ritchie, de Caestecker, Mukherjee, Mah and Meera Patel as part of this review because it was able to demonstrate that it was meeting the standards without the need for a visit.

During a routine inspection

Letter from the Chief Inspector of General Practice

In May 2016, during an announced comprehensive inspection of Drs Robertson-Ritchie, de Caestecker, Mukherjee, Mah and Meera Patel, we found issues relating to the practice’s recruitment process for new employees.

During this inspection in May the practice had informed us, that they did not routinely collect employment and character references for new members of staff, including clinical members of staff for example GPs and Nurses. This was assessed as being in breach of the Health and Social Care Act 2008 Regulations. As a result the practice was rated as requiring improvement for safe services. It was rated as good for effective, caring, responsive and well led services, and awarded an overall rating of good.

Following the inspection the provider sent us an action plan detailing how they had reviewed and were now following their updated recruitment policy, ensuring that employee and character references were sought for all new members of staff. The practice also provided retrospective employee and character references for staff employed within the last three years.

We carried out a focused inspection of the practice in September 2016 to ensure these changes had been implemented and that the service was meeting regulations.

We found the practice had made improvements since our last inspection in May 2016, and that it was meeting the regulation relating to assessing that all staff employed were of good character, which had previously been breached.

Following this focused inspection we have rated the practice as good for providing safe services. The overall rating for the practice remains as good.

This report should be read in conjunction with the full inspection report of 10 May 2016. A full copy of the report can be found on the CQC website at: www.cqc.org.uk.

At this inspection we found:

• The practice had sourced retrospective references for staff employed within the last three years.

• The practice had ensured that systems were in place in order that all staff recruited were of good character.

• The practice had reviewed its updated policy and procedures relating to staff and recruitment checks, and was now following this.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

10 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Robertson-Ritchie, de Caestecker, Mukherjee, Mah and Meera Patel on 10 May 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system for reporting and recording significant events.
  • Most risks to patients were assessed and well managed. However, the practice did not routinely collect employment or character references for new members of staff.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • 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. Improvements were made to the quality of care as a result of complaints and concerns. However, the practice had not replied to comments on the NHS Choices website.
  • Patients said that they were able to get appointments, but that getting through to the practice on the telephone could be difficult. 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. However, the entrance door to the premises did not have an automatic opening system to allow access for patients who were wheelchair users. The reception desk did not have a lower area to allow this patient group to communicate with the reception staff.
  • There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

  • Ensure the recruitment process is robust and includes collecting employment and character references.

The areas where the provider should make improvement are:

  • Review how patients who use wheelchairs access the premises and communicate with members of staff at the reception desk.
  • Review and reply to complaints on the NHS Choices website.
  • Review the care of patients diagnosed with dementia, including face to face reviews, to ensure all care needs for this group of patients were being met.
  • Revise the system that identifies patients who are also carers to help ensure that these patients are offered relevant support.
  • Review clinical audit activity to ensure improvements to patient care are driven by the completion of clinical audit cycles.
  • Review the process for appraisals for the nursing team.
  • Review how patients access appointments by telephone.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

31 July 2014

During an inspection looking at part of the service

Our inspection on the 30 December 2013 found that patients had not always been protected from the risks of infection, because the provider had not taken appropriate measures to ensure that the risk and spread of infection was minimised at all times.

We asked the provider to take action to address these concerns. They wrote to us confirming that all required actions had been taken to comply with the regulations regarding cleanliness and infection control. A planned follow-up inspection was scheduled to check that the provider had achieved compliance.

At this inspection on the 31 July 2014, we found that the provider was able to demonstrate that they had met the compliance actions set to address the areas of concern identified at our previous inspection.

30 December 2013

During a routine inspection

We spoke with four patients who told us they were satisfied with the service provided. They said they sometimes experienced difficulties obtaining a routine appointment that suited their needs. However, they told us that in an emergency they had always been seen on the same day. One person said 'I am generally pleased with the care I receive'.

We saw that treatment options and medications prescribed were discussed and sufficient time given for patients to talk about their health issues with their practitioner.

Although we found the location to be clean and tidy, we found that there were not effective systems in place to reduce the risk and the spread of infection.

We saw that patients were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

There was a system in place to ensure the provider monitored and maintained the quality of service provision at the practice.