A GP surgery in south west London has been rated inadequate for a second time by the Care Quality Commission (CQC) and remains in special measures, following an inspection undertaken in June and July.
Dr Eno and Partners, also known as The Trinity Medical Centre, was first rated inadequate following an inspection last October, where CQC identified concerns around waiting times and the standards of care being provided to people.
This latest inspection was carried out to assess whether improvements had been made and to seek assurances that patients being treated at the service were safe. CQC inspectors found there were still several issues that were putting people at risk, including insufficient staff levels to meet the needs of patients and insufficient monitoring of people on high-risk medicines.
As well as being rated inadequate overall, the service was rated inadequate for being safe, effective, responsive to people’s needs and well-led. It was rated requires improvement for being caring.
CQC has issued the service with a number of warning notices due to the repeated breach of regulations. If improvements are not made CQC will take further enforcement action which could result in the service closing. The service remains in special measures and continues to be monitored closely by CQC and NHS England.
Andy Ford, CQC head of primary care service inspection, said:
“We made it clear to Dr Eno and Partners the steps that were needed to ensure better standards of care for patients, following our inspection last October.
“Unfortunately, we haven’t seen any significant improvement and we still have a number of concerns about the care and treatment being provided to people.
“People weren’t always able to access the types of appointments they wanted and waiting times were unacceptable, but there was no plan in place to address these issues.
“Complaints weren’t always recorded, reviewed or handled properly, and there was little evidence to demonstrate that these were learnt from to improve the service.
“Staff didn’t feel supported by management, and there was a lack of effective leadership to ensure high quality, person-centred care.
“We’ve told the service what it must do to meet its legal obligations and to ensure better standards of care. We’ve issued warning notices to the service for the repeated breach of regulations, which could result in us closing the service if we don’t see immediate and far-reaching improvement, to keep people safe from harm.
The inspection found:
- There were not enough staff throughout the practice to meet the needs of people effectively or in a timely manner
- Patients’ medical records weren’t kept up-to-date or accurate and didn’t demonstrate that those with long-term conditions or on high-risk medicines were sufficiently monitored to ensure their safety
- Patients couldn’t access appointments in a timely way and weren’t always satisfied with the types of appointments they were offered
- Appropriate recruitment checks hadn’t been carried out on all staff to ensure their suitability to work at the practice
- There wasn’t enough evidence to show that GPs and staff had appropriate safeguarding training or that they had all received infection prevention and control training
- Complaints weren’t always handled satisfactorily or used to improve the service
- Governance at the service was inadequate and leaders couldn’t demonstrate they had the capacity and skills to deliver high quality care
- Staff didn’t feel supported by management and there was a high staff turnover
- There was little evidence of learning, continuous improvement or innovation at the service
- Do not attempt CPR forms and mental capacity assessments weren’t always completed correctly or in line with legislation
- Sharps bins weren’t maintained in line with national guidance.
However
- There was an active patient participation group
- All recommended emergency medicines were stocked
- Appliances and equipment had been tested for safety
- The safeguarding policy was up to date
- Infection control and health and safety audits had been completed within the last year
- A fire risk assessment had been completed.