Following a recent inspection, the Care Quality Commission (CQC) has rated Dr Poolo’s Surgery at Rush Green Medical Centre in Romford, Inadequate overall, and has issued an urgent notice to suspend the provider’s registration.
CQC carried out an unannounced focused inspection of the surgery on 22 February, as a result of concerns raised about the service. The findings from this inspection led to further inspection activity in early March, in which the scope was widened to look at the patient record system, and to carry out interviews with staff.
Following this inspection, the service was also rated Inadequate in relation to whether it was safe, effective and well-led. It was previously rated Good overall when it was inspected in March 2017. However, in September and October 2020, inspectors carried out a review of the service’s records, after which CQC sent the provider a letter outlining serious concerns about record keeping, monitoring of patients and coding of patient records.
Vicki Wells, CQC’s deputy chief inspector for Primary Medical Services (London), said:
“We have told Dr Poolo’s Surgery at Rush Green Medical Centre that it must ensure care and treatment is provided in a safe way to patients in line with current legislation. It must also establish effective systems and processes to ensure good governance, in accordance with the fundamental standards of care.
“On 18 March, we issued an urgent notice to suspend the registration of the practice in respect of regulated activities, under Section 31 of the Health and Social Care Act 2008. This is because we believe a person will, or may be, exposed to the risk of harm if we did not take this action. The provider has the right to appeal our decision. In the meantime, the practice remains open during the suspension period, but under the leadership of a different provider.”
Inspectors found numerous areas of concern, including the following:
- Leaders could not demonstrate that they had the capacity and skills to deliver high quality sustainable care.
- The practice did not have clear systems to support good governance and management, for example in relation to systems for managing safety alerts, processes to appropriately diagnose, monitor and manage patients, arrangements for supervision and record keeping checks, and safeguarding arrangements.
- The practice did not have clear systems, practices and processes to keep people safe and safeguarded from abuse.
- Appropriate recruitment checks were not always carried out.
- Inspectors could not be assured that patient records were written and managed securely, in line with current guidance, or that staff had the information they needed to deliver safe care and treatment.
- The practice was coding medication reviews that had taken place, but there was no recorded evidence of a structured medication review carried out by a clinician.
- CQC identified examples where patients presenting with symptoms indicating possible serious illness were not followed up in a timely or appropriate way.
- Inspectors found evidence of a clinician acting beyond their scope of practice in relation to clinical reviews and decision-making, with no evidence of escalation to, or involvement of, a GP.
- There was poor monitoring and management of patients with long-term conditions, such as diabetes and asthma. Inspectors were not assured that dementia and mental health care plan reviews were being carried out properly or being adequately documented.
- The practice did not have effective processes for managing risks, issues and performance. Several risks to patient safety were identified which had not been recognised, or acted upon, by the practice prior to the inspection.
Full details of the inspection are given in the report published online here.
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