CQC rates two Barnsley GP practices as Inadequate

England’s Chief Inspector of General Practice has rated two Barnsley GP practices as Inadequate following inspections by the Care Quality Commission.

Both practices were inspected in December 2014 by specialist inspection teams which included GP advisors, and a practice manager.

The service provided by Wombwell Medical Centre, in Wombwell, Barnsley was rated as Inadequate for being safe and well-led, and Requires Improvement for being effective and responsive. The practice was rated Good for being caring and has been given an overall rating of Inadequate.

At Caxton House Surgery in Grimethorpe Barnsley inspectors rated the service as Inadequate for being safe and well-led, and Requires Improvement for being effective and responsive. The practice was rated Good for being caring and has been given an overall rating of Inadequate.

Under CQC’s new programme of inspections led by Professor Steve Field, Chief Inspector of General Practice, all of England’s GP practices are being inspected and given a rating.

A full report of both inspections has been published today:

• Wombwell Medical Centre
• Caxton House Surgery

At Wombwell Medical Centre inspectors received positive feedback from patients they spoke to during the inspection. Patients were happy with the care and treatment they had received and said they were able to get an appointment reasonably quickly. However, some patients told inspectors that they often had to wait too long after their appointment time to be seen.

Although staff understood and fulfilled their responsibilities to raise concerns and incidents, reviews and investigations were not always carried out, and lessons learned were not shared with staff to support improvement.

Concerns were also raised about medicines management, infection control and emergency procedures, and inspectors found that the practice did not have effective systems to manage and review risks to vulnerable children, young people or adults.

The Care Quality Commission has identified a number of areas for improvement, including:

• The practice must ensure there are systems to regularly assess and monitor the quality of the service, and that governance arrangements are in place and staff are aware how these operate.
• The practice must ensure that patients are safeguarded against the risk of abuse.
• The practice must take action to protect patients, staff and others against identifiable risks of acquiring healthcare associated infections.
• The practice must ensure medicines are managed appropriately.
• The practice must provide staff with appropriate support and training to fulfil their roles.
• The practice must ensure that recruitment arrangements include all necessary employment checks for all staff.

At Caxton House Surgery patients were complimentary about the GPs, the reception staff and the care and treatment they received. They said they could usually get an appointment when they wanted one and their appointments were not rushed. Inspectors saw that patients were involved in decisions about their care and treatment and were treated with compassion, dignity and respect.

However inspectors also found a number of areas where improvements were needed. The practice did not have a clear system in place for handling complaints and concerns. There were no written records of complaints received and no system to record verbal concerns about the practice.

Non-clinical staff had received an annual appraisal and staff told inspectors that they had discussed further training, however, there were no records of any learning needs assessments or future training plans.

Systems and procedures to manage standards of cleanliness and infection control were not always reliable or appropriate to keep patients safe and inspectors raised concerns that the needs of the local population were not fully identified or taken into account when planning services.

The Care Quality Commission has identified a number of areas for improvement, including:

• The practice must ensure that staff are aware of and follow adult and children safeguarding policies and infection control policies and procedures.
• The practice must ensure that legally required checks are carried out before new staff are appointed and that staff receive annual CPR training.
• The practice must ensure patients can access copies of the practice’s complaints procedure, and that this procedure is in accordance with the NHS England Standard General Medical Services contractual requirements.
• The practice must put arrangements in place for identifying, recording and managing risks of inappropriate or unsafe care and treatment.
• The practice must ensure that systems are in place to regularly assess and monitor the quality of the services provided.
• The practice must ensure that fire safety equipment is checked and marked to show when servicing or replacement is required.

CQC has been working closely with Barnsley Clinical Commissioning Group and NHS England to support both practices while they address the issues identified by inspectors.

Sue McMillan, Deputy Chief Inspector of General Practice said:

“Patients should be able to expect high quality and consistent care from their GP practice.

“At both these practices we found caring services and patients spoke highly of the care and treatment they received. However, we also found some significant areas of concern and improvements are needed to assure safe, effective, responsive and well led services.

“I do not believe that either practice is likely to resolve its challenges without external support. This is why we are placing both into special measures.

“With the right support, I expect both practices to be transformed. After a period of six months we will inspect again to check whether sufficient improvements have been made. If we find that the service provided at either practice remains inadequate, we will consider taking steps to cancel its registration with CQC.”

Patients registered with practices being placed into special measures should be aware that the package of support being offered by NHS England and the Royal College of GPs will ensure that there are no immediate risks to patient safety at these GP practices whilst improvements are being made. These practices will not close.

Ends

For further information please contact CQC Kirstin Hannaford on 0191 233 3629 or David Fryer on 0790 151 4220.

For media enquiries about the Care Quality Commission, please call the press office on 020 7448 9401 during office hours. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here (please note: the duty press officer is unable to advise members of the public on health or social care matters). For general enquiries, please call 03000 61 61 61.