In November 2018, four local practices joined together and formed a new partnership called Riverport Medical Practice. They became the provider for Orchard Surgery St. Ives and three other branch sites, Park Hall and Northcote House and Fenstanton.
The address and inspection history of each site is;
- Orchard Surgery St. Ives (the registered location), Constable Road, St. Ives, Cambridgeshire. PE27 3ER. Previous inspections were:
A comprehensive inspection was carried out in July 2017 and the practice was rated as good overall. A comprehensive inspection was carried out in November 2016 and the practice was rated as inadequate and placed in special measures.
- Parkhall site, 2C, Parkhall Road, Somersham, Cambridgeshire. PE28 3EU.
A focussed inspection was carried out in December 2016 and the practice was rated as good for providing safe services. A comprehensive inspection was carried out in May 2016 and the practice was rated as good overall and requires improvement for providing safe services.
- Northcote House site, 8 Broad Leas, St Ives, Cambridgeshire. PE27 5PT and Fenstanton site, 7E, High Street, Fenstanton, Cambridgeshire. PE28 9LQ
A comprehensive inspection was carried out in December 2016 and the practice was rated as good overall. A comprehensive inspection was carried out in April 2016 and the practice was rated as inadequate and placed in special measures.
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Orchard Surgery St Ives on 21 March 2019 as part of our inspection programme.
At this inspection we found:
- In November 2018 the GP partners acknowledged that as three individual practices they were struggling to meet patient demands and to sustain services, the three practices merged to form a new partnership Riverport Medical Practice. This had resulted in the leaders having confidence to share resources, skills and expertise to benefit patients and staff.
- The practice had met the challenges of implementing a new clinical system to enable all sites to access to the patient records, staff changes and co-ordinated standard working procedures across all sites.
- The management team recognised the significant work that had been undertaken and recognised there were still systems and processes to fully embed and others that required further improvement.
- Staff we spoke with told us they were proud of the improvements the merger had made for their patients. For example, greater skill mix and expertise shared across the sites.
- The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. They recognised that the recording of these events lacked detail to be fully assured that trends would be identified and actions monitored.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
We rated the practice as requires improvement for delivering safe services because;
- The system and process to ensure all medicines were stored safely needed to be improved as we found some out of date medicines, gases and equipment. The practice took immediate action to address the issues.
- The system and process to ensure all appropriate emergency medicines were available needed to be improved as we found missing items at two of the sites. The practice took immediate action and obtained them.
- We saw the practice had a programme of training but some staff were overdue training that the practice had deemed mandatory.
- The practice was knowledgeable about the patients on their safeguarding register but they did not have a formalised approach to multi-disciplinary team management of safeguarding concerns.
- We found no concerns relating to infection prevention and control but the policies needed to be improved to ensure all information was easily available to all staff to maintain the standards required.
The areas where the provider must make improvements as they are in breach of regulations are:
- 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:
- Improve the systems and processes in place to ensure significant events and complaints are recorded in detail to record actions taken, learning identified and to monitor improvements made.
- Review the practice performance, including clinical oversight for exception reporting and consistent coding of medical records to ensure all patients receive appropriate follow up in a timely manner.
- Review and further develop systems and processes to encourage the uptake of the childhood immunisation programme.
- Continue to work with patients to encourage the development of a patient participation group.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care