The Care Quality Commission (CQC) has rated Village Surgery in New Malden inadequate for a second time and has taken steps to cancel its registration, if immediate improvements aren’t made, following an inspection in February.
The service was first rated inadequate in September and placed in special measures. CQC has closely monitored its progress, but the latest inspection found that insufficient improvements have been made and the rating remains the same.
CQC is proposing to close the surgery unless it is satisfied significant improvements have been made.
Following the latest inspection, Village Surgery was rated inadequate overall as well as for being safe, effective, caring and well-led. It was rated requires improvement for being responsive to people’s needs.
Andy Ford, CQCs head of primary care service inspection, said
“It is extremely disappointing that Village Surgery had not improved since the last inspection, despite CQC telling it where changes must be made. It was not providing safe care and treatment for people and was putting patients at risk.
“Hundreds of medication reviews were still overdue and there were still patients on high-risk prescription medicines that were not being monitored. No processes had been put in place to adequately identify vulnerable patients or safeguarding concerns, and the service had not addressed issues around health and safety on the premises.
“In line with our enforcement procedures we have begun the process to prevent this service from operating if immediate improvements are not made. We will be keeping the service under close review and if it is necessary to keep people safe, this will be escalated to more urgent enforcement action.”
There was no evidence of actual patient harm at the latest inspection, however CQC’s findings included:
- The practice was still not monitoring all patients on high-risk prescription medicines.
- There were still hundreds of overdue medication reviews.
- There were hundreds of overdue monitoring actions for patients with long-term conditions such as diabetes and hypertension.
- There were limited risk assessments for the premises, which had not addressed earlier concerns raised by CQC.
- Staff did not know how to support non-English speakers to communicate with the service.
- Expired clinical equipment or items were found in all clinical treatment rooms.
- There was still no system for identifying, monitoring or communicating internally about vulnerable patients or safeguarding concerns.
- Some staff had still not completed safeguarding training or completed it to the correct level.
- Not all emergency medicines were stocked.
- There were no records of patient survey analysis or feedback.
- There were no audits of complaints and some complaints had not been recorded as having a response.
- Staff still hadn’t completed mandatory training.
CQC found breaches of regulations and has told Village Surgery it must:
- Ensure care and treatment is provided safely to patients.
- Ensure patients’ assessments, care and treatment are provided effectively.
- Establish effective systems and processes to ensure good governance in accordance with fundamental standards of care.
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