The Care Quality Commission
  • Doctor
  • GP practice

Archived: Iwade Health Centre

Overall: Good read more about inspection ratings

1 Monins Road, Iwade, Sittingbourne, Kent, ME9 8TY (01795) 413100

Provided and run by:
DMC Healthcare Limited

Important: The provider of this service changed. See old profile
Important: We are carrying out a review of quality at Iwade Health Centre. We will publish a report when our review is complete. Find out more about our inspection reports.

All Inspections

19 October 2021

During an inspection looking at part of the service

We carried out an announced focussed inspection at Iwade Health Centre on 9 October 2020. The practice was not rated as a consequence of this inspection. The full comprehensive report on the October 2020 inspection can be found by selecting the ‘all reports’ link for Iwade Health Centre on our website at www.cqc.org.uk.

After our inspection in October 2020 the practice wrote to us with an action plan outlining how they would make the necessary improvements to comply with the regulations.

We carried out an announced focussed follow-up review on 25 May 2021 to assess the provider’s compliance to meet the legal requirements against the warning notices issued in relation to breaches in regulations that we identified at our previous inspection in October 2020. The practice was not rated as a consequence of this review. The full report on the May 2021 review can be found by selecting the ‘all reports’ link for Iwade Health Centre on our website at www.cqc.org.uk.

After our review in May 2021 the practice wrote to us with an action plan outlining how they would make the necessary improvements to comply with the regulations.

Why we carried out this review:

We carried out an announced focussed follow-up inspection on 19 October 2021 (at short notice) to assess the provider’s compliance to meet the legal requirements against the requirement notice issued in relation to the breaches in regulations that we identified in our previous review in May 2021. This report covers findings in relation to those requirements.

How we carried out the review:

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was in line with all data protection and information governance requirements.

This included:

  • Requesting evidence from the provider.
  • A short site visit.

Our judgement of the quality of care at this service is based on a combination of what we found when we carried out the review, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

This practice was not rated as a consequence of this inspection.

At this inspection we found:

  • Risk assessments failed to contain sufficient rationale for the lack of hepatitis B vaccination records for one member of clinical staff.
  • The practice’s induction system for temporary staff had not been updated in a timely manner and not all staff were up to date with basic life support training.
  • The practice’s reception had been closed to staff since June 2021 which was not in line with NHS England standard operating procedures.
  • Improvements had not been sufficiently effective and were still required to ensure that all staff followed best practice guidance when carrying out reviews of patients diagnosed with chronic obstructive pulmonary disease (COPD).
  • Requirements of some staff to provide practice clinical leadership (or clinical supervision) in the absence of the clinical lead salaried GP were not included in their written job descriptions.
  • Improvements to the management of some current and future performance were not yet sufficiently effective and other risk management improvements were required.

The areas where the provider must make improvements are:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

25 May 2021

During an inspection looking at part of the service

We carried out an announced focussed inspection at Iwade Health Centre on 9 October 2020. The practice was not rated as a consequence of this inspection. The full comprehensive report on the October 2020 inspection can be found by selecting the ‘all reports’ link for Iwade Health Centre on our website at www.cqc.org.uk.

After our inspection in October 2020 the practice wrote to us with an action plan outlining how they would make the necessary improvements to comply with the regulations.

Why we carried out this review:

We carried out an announced focussed follow-up review on 25 May 2021 to assess the provider’s compliance to meet the legal requirements against the warning notices issued in relation to the breaches in regulations that we identified in our previous inspection in October 2020. This report covers findings in relation to those requirements.

How we carried out the review:

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This review was carried out in a way which enabled us to regulate the provider remotely. This was in line with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using video conferencing.
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.

Our judgement of the quality of care at this service is based on a combination of what we found when we carried out the review, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

This practice was not rated as a consequence of this review.

At this review we found:

  • The provider had made improvements to their systems, practices and processes to help keep people safe.
  • Risks to patients, staff and visitors were now being assessed, monitored or managed in an effective manner.
  • The provider had reviewed the way clinical staff carried out reviews of the care of patients diagnosed with chronic obstructive pulmonary disease (COPD). However, further improvements were required to ensure all staff followed best practice guidance when carrying out these reviews
  • The arrangements for medicines management had been revised and improved to help keep patients safe.
  • The provider had made improvements to local clinical leadership (including clinical supervision) and the Registered Manager was now visible in the practice on a monthly basis.
  • Improvements had been made to governance arrangements. However, further improvements were still required.
  • Appraisals that were overdue had been carried out to help the provider involve staff to help maintain high-quality and sustainable care.
  • The provider had reviewed their systems and processes for learning and continuous improvement to make them more effective.

The areas where the provider must make improvements 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:

  • Continue with plans to establish the vaccination status of all relevant staff and ensure they are offered relevant vaccinations in line with current Public Health England guidance.
  • Continue with plans for relevant staff to attend basic life support training.
  • Consider further revision of governance documents to make them clearer for staff to follow in relation to clinical supervision arrangements at Iwade Health Centre and ensure they are in date and ratified.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

9 October 2020

During an inspection looking at part of the service

We carried out an announced focussed inspection (at short notice to the provider) at Iwade Health Centre on 9 October 2020. The practice was not rated as a consequence of this inspection.

Following the inspection in July 2020 of another location where services were also delivered by the provider DMC Healthcare Limited, we found breaches of regulation and the risk of patient harm. As a result, we took urgent enforcement action and removed that location from the provider’s registration with CQC. This prevented them from continuing to deliver regulated activities at that location. As the provider DMC Healthcare Limited is also delivering regulated activities at Iwade Health Centre, we carried out this inspection to assure ourselves that the breaches of regulation and risk of patient harm found during the inspection of the other location in July 2020 were not being repeated at this location.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations. The on-site inspection activity took place on 9 October 2020 followed by inspection activities carried out remotely thereafter.

At this inspection we found:

  • The practice’s systems, practices and processes did not always keep people safe.
  • Risks to patients, staff and visitors were not always assessed, monitored or managed in an effective manner.
  • Staff did not always have the information they needed to deliver safe care and treatment.
  • The arrangements for medicines management did not always help to keep patients safe.
  • The practice learned and made improvements when things went wrong.
  • Local clinical leadership (including on-site clinical supervision) was unclear and the Registered Manager was not visible in the practice.
  • Governance arrangements were not always effective.
  • The practice involved the public, staff and external partners to help sustain high-quality sustainable care. However, engagement was limited due to the current pandemic.
  • Systems and processes for learning and continuous improvement were not always effective.

The areas where the provider must make improvements 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.

The areas where the provider should make improvements are:

  • Continue with plans for relevant staff to attend chaperone training, fire safety training as well as infection prevention and control training.

We are mindful of the impact of COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Please refer to the detailed report and the evidence tables for further information.