Steeple Bumpstead Surgery near Haverhill is taking steps to improve after Care Quality Commission rates it as 'inadequate'
The Community Interest Company that runs Steeple Bumpstead Surgery says that staffing issues is the root cause of the rating of 'inadequate' that has been given to it by the Care Quality Commission (CQC)
Provide has also said that steps are being redress the problems that led to CQC inspectors giving the surgery in Bower Hall Drive the rating and placing it in special measures for six months.
The inspection in February followed up on areas where the CGQ said the practice required improvement as identified in its inspection of July 2017 as well as to provide new ratings.
The surgery, which has 2,500 registered patients, was rated as inadequate overall, and the core areas of being safe, well-led and effective also received the same rating.
The inspection did though, award a rating of 'good' to patient careand a rating of 'requires improvement' to how responsive the surgery is.
Among its conclusions, the CQC said "Checks of equipment and premises were not reliable" and "there was a reliance on clinical locum staff but not a consistent and safe approach to managing absences of these clinicians.
A statement from Provide said: "Provide CIC has successfully run the Steeple Bumpstead Surgery since 1 June 2013.
"The practice was recognised in 2016 as one of the first dementia friendly practices in Essex and in July 2017 received a CQC rating of ‘Good’.
"The surgery is a relatively small practice and currently struggles to provide consistent General Practice services, due mainly to staffing issues.
"This has resulted in the poor rating by the Care Quality Commission (CQC). However, the CQC recently rated Provide as ‘Outstanding’ for the other services that it delivers.
Jayne Peden, assistant director, primary and prevention services said: "Provide and the commissioners, West Essex CCG, are taking action to redress the situation, including: implementing changes to resolve the issues identified by the CQC; working with local GP providers to supply practice management and clinical capacity; for the future, investigating options with nearby practices for combining services, eg a branch surgery.
"I must stress that patient safety has not been compromised and is being closely monitored."
The inspection report also stated the following:
n There had not been a multi-disciplinary meeting involving other healthcare professionals since September 2018, despite this being identified as a required action following concerns raised at the end of 2018.
n Prescription stationery and medicines were not held securely.
There were no systems for clinical support and supervision of staff.
n There were no documents to define the prescribing remit of the advanced nurse practitioner.
We rated the practice as inadequate for effective because:
n Performance was below average in respect of diabetes, asthma, COPD, cancer and mental health. Identified improvements had not been made following our 2017 inspection.
n Information about patients was not shared with other healthcare professionals at a regular meeting with a view to ensuring continuity of care.
n Information cascades were not effective.
n There was a lack of quality improvement processes in place for example, there had been no clinical audits completed in the last two years.
n The learning and development needs of clinical locum staff were not assessed.
We rated the practice as requires improvement for responsive because:
n Feedback in the GP patient survey was in line with or better than averages in relation to access; however, some patients raised concern about accessing appointments.
n There had been occasions where appointments had to be cancelled by the practice at short notice due to a lack of clinicians.
n We rated the practice as inadequate for well-led because:
n The provider was unaware of some challenges to safety and effectiveness at the practice.
n The provider’s vision had not been effectively incorporated into the day to day running of the practice.
n There was limited effective oversight.
Patients and others were not confident that concerns would be responded to.
n We rated the practice as good for caring because:
n Feedback in relation to the care and treatment provided was positive. Patients had trust and confidence in the clinical staff.
The areas where the provider must make improvements as they are in breach of regulations are:
n Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
The areas where the provider should make improvements are:
n Improve processes for ensuring medical equipment is suitable for use for example, to ensure anaphylaxis packs have a tamper evident seal on them.
n Define and make staff and patients aware of the clinical remit of the advanced nurse practitioner.
n Review the space and environment of the dispensary. Ensure staff are aware of who has overall responsibility of the dispensary.
n Consider mechanisms for obtaining patient feedback such as implementation of an in-house patient survey.
n Review the protocol to offer support to patients affected by bereavement.
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, the CQC will take action in line with its 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.