Archived: New Inn Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Inn Surgery on 21 October 2014. Overall the practice is rated as inadequate.

Specifically, we found the practice inadequate for providing safe services and being well led. It was also inadequate for providing services for all the population groups. Improvements were also required for providing effective and responsive services. We found the practice was good for providing caring services.

The areas where the provider must make improvements are:

• Improve staff awareness of protecting patients from abuse and who to report concerns to.
• Improve the management of medicines in relation to the safe storage and administration of vaccinations and immunisations.
• Take action to address identified concerns with infection prevention and control practice.
• Ensure recruitment arrangements include all necessary employment checks for all staff.
• Develop a system to ensure all staff receive the appropriate mandatory and other training appropriate to their role. For example: Mental Capacity Act 2005, chaperoning and infection control.
• Provide suitable support for all staff, including appropriate supervision and professional development.
• Ensure there are formal governance arrangements in place including systems for assessing and monitoring risks and the quality of the service provision.
• Ensure staff have appropriate policies and guidance to carry out their roles.
• Manage complaints, comments and compliments from patients and staff, acting on feedback to improve services.

The areas where the provider should make improvement are:

• Clarify the leadership structure and ensure there is leadership capacity to deliver all improvements.
• Identify the population needs of the practice and improve services for all patients.
• Ensure emergency equipment is available for use and is in good working order.

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

• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example, appropriate recruitment checks on staff had not been undertaken prior to their employment and actions identified to address concerns with infection control practice had not been taken. Safeguarding systems were not robust and staff were unsure of how to identify potential abuse and who to report this to.
• Medicines management systems did not protect patients from the unsafe use of medicines.
• Staff were not clear about reporting incidents, near misses and concerns and there was no evidence of learning and communication with staff.
• Patients were positive about their interactions with staff and said they were treated with compassion and dignity.
• The practice achievement for the management and monitoring of patient outcomes demonstrated they were an outlier and poorer performer when compared to clinical commissioning group and national data.
• Urgent appointments were usually available on the day they were requested.
• The practice had no clear leadership structure, insufficient leadership capacity and limited formal governance arrangements.

On the basis of the ratings given to this practice at this inspection, I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care, we will take steps to cancel its registration with CQC.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice