21 March 2019
During a routine inspection
This inspection was a focused inspection to follow up on concerns identified previously at inspections conducted on the 10 May 2018 and 11 October 2018.
At the inspection on 10 May 2018 we found the practice was not meeting the regulations for providing safe, effective and well-led care. There were breaches in relation to the following regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Regulation 17 Good governance and Regulation 18 Staffing. Following the inspection, enforcement action was taken in respect of these regulations.
The inspection on 11 October 2018, was carried out to consider whether the provider had made sufficient improvements to meet the regulations in breach. At the inspection, we found insufficient evidence of improvement with continuing breaches of Regulation 17 Good governance and Regulation 18 Staffing. Following the inspection, we took further enforcement action and decided to begin the process of preventing the provider from operating the service. This inspection on 21 March 2019 was carried out to further assess whether any improvement had been made since the previous inspections. At the inspection, we found insufficient evidence of improvement with continuing breaches of Regulation 17 and 18.
Our key findings were:
- There were continuing shortfalls in safety systems and processes. Including those for safeguarding, recruitment, indemnity arrangements, medical emergencies, prescribing, identity checks and the safety netting of abnormal test results.
- We identified additional concerns in relation to assessing and triaging walk-in patients.
- There were continuing shortfalls in relation to effective needs assessment, staff training, the monitoring of clinical practice and parental consent to care and treatment.
- There had been no improvement in leadership or governance arrangements.
- Systems were in place to gather feedback from patients.
- The arrangements in respect of the duty of candour had improved.
Dr Rosie Benneyworth BM BS BMedSci MRCGP Chief Inspector of Primary Medical Services and Integrated Care