The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Paramundayil Joseph Also known as Dill Hall Surgery

Overall: Inadequate read more about inspection ratings

6-8 Church Street, Church, Accrington, Lancashire, BB5 4LF (01254) 617911

Provided and run by:
Dr Paramundayil Joseph

All Inspections

29 November 2023

During a routine inspection

This service is rated inadequate. We were able to gather sufficient evidence to make a judgement on safe, effective, responsive and well-led, which were all rated as inadequate. We carried over the previous rating of caring which was good.

We carried out an unannounced focused inspection at Dr Paramundayil Joseph on the 29 November 2023 in response to concerns raised about the safety of the service provided to patients.

We returned to the practice to gather further evidence on 12 December 2023 and found the provider had ceased delivering regulated activities and the patient list had been transferred to another registered provider. We were therefore unable to complete the inspection.

The provider has since cancelled their registration and is no longer registered with the CQC as a provider at this location .

The registered provider was the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

  • Safeguarding procedures had not been developed to ensure patients were protected from abuse and harm. It was not possible to establish whether all staff were trained in safeguarding procedures and the lead GP was unable to explain the safeguarding procedures.
  • Health and safety was not well managed. There was no evidence of regular fire safety checks and fire safety training being carried out.
  • There was minimal oversight and monitoring of patients on multiple medicines that can cause dependence.
  • Clinical searches found areas where clinical care for patient with long term conditions had not been monitored and managed to ensure patients received safe care.
  • There was no evidence of quality improvements for the ongoing development of the service.
  • Additional nursing clinical hours were not provided when concerns were raised about patient access to services.
  • The provider could not explain how the practice adjusted the delivery of its services to meet the needs of patients with a learning disability.
  • There was no evidence that the outcome of patient complaints had been linked to the overall development and improvement of the service.
  • The way the practice was led and managed did not always promote the delivery of high quality person centred care.
  • There was no evidence of a leadership development programme practice.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care

26 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Paramundayil Joseph on 26 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 in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • 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. However, we noted action was ongoing to embed a system for the retention of complaint records.
  • 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.
  • The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

  • Action had been taken to centralise practice management activity between Dr Paramundayil Joseph and the other practice operating from the same building. As a result learning from incidents and complaints was now shared through joint practice meetings.

However there were areas of practice where the provider should make improvements:

  • Ensure the practice recruitment policy includes a requirement to confirm professional indemnity arrangements for nursing staff are in place in accordance with professional registration and legislative requirements.

  • Clearly define the infection, prevention and control (IPC) lead role and responsibilities to enable the effective oversight and completion of IPC activity.

  • Ensure comprehensive records of complaints are maintained to support learning and improvement.

  • Ensure that the system in place to monitor expiry dates of medicines and associated items is effective.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice