Beeches Surgery Also known as Drs Froley & Ghoorbin

Updated 19 December 2022

Beeches Surgery provides primary medical services in 9 Hill Road, Carshalton, Surrey SM5 3RB to approximately 5,700 registered patients and is one of the 23 practices in Sutton Local Area Team and part of the South West London Integrated Care System (ICS).

The clinical team at the surgery is made up of two part-time male lead GP partners, one part-time female salaried GP and five part-time long-term locum GPs, a full time female advance nurse practitioner, a part time female long-term locum nurse and a part time female healthcare assistant. The non-clinical practice team consists of two part-time practice managers, and a team of administrative and reception staff members.

The practice is registered as a partnership with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.

Updated 19 December 2022

We carried out an announced comprehensive inspection at Beeches Surgery in August 2022. Overall, the practice is rated as requires improvement.

Safe - requires improvement

Effective - good

Caring - good

Responsive - good

Well-led - inadequate

The practice has been inspected on five previous occasions:

• January 2015 - rated inadequate overall and placed in special measures. Concerns included not having appropriate arrangements in place for processing prescriptions, inadequate systems for the reduction of healthcare associated infection control processes, inadequate systems to safeguard patients from abuse and poor leadership structures.
• November 2015 - rated as requires improvement overall. We found improvements but also found two breaches of regulations concerning recruitment checks and managing risks.
• May 2017 we found no breaches and the practice was rated as good.
• June 2019 - rated as requires improvement overall. We found issues in relation to safety systems and processes, medicines management, management of significant events, outcomes for patients with long-term conditions, monitoring and seeking consent, complaints management and access to appointments.
• 30 September 2021- rated as as requires improvement overall. We found the provider had made some improvements in providing safe and well led services, but we found new issues in recruitment, medicines management and systems to manage safety, including systems to identify, manage and mitigate risks.

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

Why we carried out this inspection

We carried out this inspection to breaches of regulation from a previous inspection. We inspected all of the key questions.

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.
• Receiving feedback from staff using questionnaires
• 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 found that:

• Systems and processes put in place to manage risks were not being monitored to ensure they were working effectively. Some risks were not being well managed. Risks that were not being well managed in areas we had previously requested the provider to improve.
• These issues had not been identified and rectified by the provider’s own systems and processes.
• 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.
• There was mixed feedback about whether people were able to access care and treatment in a timely way.

We found breaches of two regulations. The provider must:

• Ensure that care and treatment is provided in a safe way for patients.
• Establish effective systems and processes to ensure good governance in accordance with fundamental standards of care.

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

The areas where the provider should make improvements are:

• Carry out a fuller assessment of whether changes made to levels of staff resource and support for non-clinical staff address the concerns raised.

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