Archived: Riverbank Medical Service

We carried out an announced comprehensive inspection at Riverbank Medical Services on 10 August 2022. Overall, the practice is rated as inadequate.

Safe - Inadequate

Effective - Inadequate

Caring - Good

Responsive - Good

Well-led – Inadequate

On 15 August 2022, Riverbank Medical Service was issued with an urgent notice to impose conditions upon their registration as a service provider in respect of regulated activities, under Section 31 of the Health and Social Care Act 2008. This notice of decision to impose urgent conditions was given because we believed that patients would or may have been exposed to the risk of harm if we did not take this action.

Following our previous inspection on 23 July 2018 the practice was rated Good overall and for all key questions.

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

Why we carried out this inspection

We carried out this inspection as the provider had a change in registration from a partnership to a single-handed provider on 31 July 2019.

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 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:

• The practice did not have adequate systems, practices and processes to keep people safe and safeguarded from abuse.
• There were gaps in systems to assess, monitor and manage risks to patient safety.
• Patients’ needs were not assessed, and care and treatment was not delivered in line with current legislation.
• The practice did not have a comprehensive programme of quality improvement activity.
• The practice was unable to demonstrate that staff had the skills, knowledge and experience to carry out their roles.
• Staff did not always work effectively together and with other organisations to deliver effective care and treatment.
• Staff were not consistent and proactive in helping patients to live healthier lives.
• Services did not always meet patients’ needs.
• Leaders could not demonstrate that they had the capacity and skills to deliver high quality sustainable care.
• The overall governance arrangements were inadequate.

The areas where the provider must make improvements are:

• Ensure that care and treatment is provided in a safe way.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.

The areas where the provider should make improvements are:

• Continue to implement a programme to improve uptake for cervical screening.

I am, therefore placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement, we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration. Special measures will give people who use the service the reassurance that the care they get should improve.

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