Background to this inspection
Updated
26 February 2019
Federated General Practice Partnership Limited registered with the Care Quality Commission (the Commission) in October 2017 to provide services at Dodworth medical practice, High Street, Dodworth, Barnsley, S75 3RF for 5,486 patients as part of the personal medical services contract with NHS Barnsley Clinical Commissioning Group on behalf of NHS England. Further information can be found on the practice website www.apollocourtmedicalcentre.nhs.uk .
The two Directors of Federated General Practice Partnership Limited have other separate provider registrations with the Commission.
Dodworth medical practice (located within Apollo Court Medical Centre) is situated in centre of the village of Dodworth. The catchment area, which includes villages local to the surgery, is classed as within the fifth less deprived areas in England. Income deprivation indices affecting children and older people are experienced less in this area compared to local and national averages. The practice population is similar to that of others in the area, however, there are more patients registered here over the age of 65 years old.
Out of hours care can be accessed via the surgery telephone number or by calling the NHS 111 service.
There is one male sessional GP who works four sessions a week, a long term GP locum who works six sessions a week and three long term locums who work at the practice one day a week. GP sessions on Fridays are covered by locums. There is a part-time male advance nurse practitioner who works three days a week, a practice nurse who works four days a week and a healthcare assistant. A consultant practice manager works at the practice one and a half days a week and there is a team of administrative and reception staff. A group practice director, a healthcare assistant and a senior receptionist from another organisation also work at the practice.
The practice opening hours are from 8am to 6pm Monday to Friday with appointments available on Tuesday evening until 8pm.
Appointments were also available with GPs and practice nurses at the i-Heart Barnsley service between:
- 6pm and 10pm on weekdays
- Saturday, Sundays and bank holidays from 9am to 1pm.
Federated General Practice Partnership Limited is registered with the Commission to provide the following regulated activities:
- Diagnostic and screening procedures
- Treatment of disease, disorder or injury
- Maternity and midwifery services
- Surgical procedures
Updated
26 February 2019
This practice is rated as inadequate overall.
We carried out an announced focused inspection at Dodworth medical practice on 28 November 2017 following feedback to the Care Quality Commission. As we did not look at the overall quality of the service we were unable to provide a rating for the service. We found shortfalls in relation to the recruitment of staff which resulted in a breach of regulation. The focused report on the November 2017 inspection can be found by selecting the “all reports” link for Dodworth Medical Practice on our website at www.cqc.org.uk.
This inspection was an unannounced comprehensive inspection at Dodworth medical practice on 10 and 13 July 2018 and was prompted following information of concerns raised with the Commission.
The key questions are rated as:
Are services safe? – Inadequate
Are services effective? – Requires improvement
Are services caring? – Not rated
Are services responsive? – Requires improvement
Are services well-led? - Inadequate
At this inspection we found:
- We found significant concerns in the leadership and governance of the practice. The provider did not have a systematic approach when taking over this practice to assess the risks in order to provide adequate leadership to support the governance systems.
- The practice did not have clear systems in place to manage risk so that safety incidents and significant events were less likely to recur. When incidents did happen, the practice did not effectively learn from them and improve their processes.
- There was little understanding or management of risks and issues, and there were significant failures in performance management and audit systems and processes. There were very few risk or issue registers in place. Those that were in place were rarely reviewed or updated.
- The practice did not routinely review the effectiveness and appropriateness of the care it provided. It did not ensure that care and treatment was delivered according to evidence- based guidelines. Staff groups tended to take the lead rather than be driven by the leadership of the practice.
- Not all staff members had received the training required to carry out their roles effectively. For example, safeguarding, infection and prevention control and fire safety.
- On the day of inspection we saw staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients told us the appointment system had recently improved, it was easy to use and care could be accessed when needed. However, patients reported lack of continuity of care when seeing doctors.
The areas where the provider must make improvements as they are in breach of regulations are:
-
Ensure care and treatment is provided in a safe way to patients.
-
Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
-
Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
-
Ensure specified information is available regarding each person employed
The areas where the provider
should
make improvements are:
-
Review the approach for identifying and providing support to patients with caring responsibilities.
I am placing this service in special measures. 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, we will take action in line with our 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.
The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.
Special measures will give people who use the service the reassurance that the care they get should improve.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice