Background to this inspection
Updated
30 July 2019
Rooksdown Practice is located at Park Prewett Medical Centre, Park Prewett Road, Basingstoke, Hampshire, RG24 9RG. Rooksdown Practice is part of Cedar Medical Limited.
The practice is registered with the Care Quality Commission to provide the following regulated activities:
- Surgical procedures;
- Treatment of disease, disorder or injury;
- Family planning;
- Maternity and midwifery services;
- Diagnostic and screening procedures.
Rooksdown Practice occupies a purpose built medical centre that opened in May 2017. The premises are owned by NHS England via their estates division.
The practice provides services under a Personal Medical Services contract and is part of the NHS North Hampshire Clinical Commissioning Group (CCG). The practice, has approximately 13,800 registered patients. The practice has an above average working age population particularly for those between 25 and 45 years old. The practice has 80% of registered patients in paid employment in comparison to the national average of 62%. The practice has a lower than average elderly population, 7% in comparison to the national average of 17%. This percentage drops to 3% for the over 75 age group in comparison to a national average of 8%. The patient population is predominantly White British but there are patients from other nationalities including Polish, Hungarian and Asian.
The Rooksdown Practice has opted out of providing out-of-hours services to their own patients and refers patients to the out of hour’s service via the NHS 111 service.
Rooksdown Practice has a branch surgery located at The Beggarwood Surgery, Broadmere Road, Basingstoke, Hampshire. RG22 4AG. We visited this branch surgery during the inspection of Rooksdown Practice.
Updated
30 July 2019
We carried out an announced comprehensive inspection at Rooksdown Practice on 22 January 2019.
At this inspection we followed up on breaches of regulations identified at a previous inspection on 17 January 2018. Specifically, it was previously identified that systems were not formalised to ensure that there was overall governance, leadership and quality improvement across the practice and the branch.
We based our judgement of the quality of care at this service 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.
We have rated this practice as inadequate overall.
We rated the practice as inadequate for providing safe services because:
- The practice’s processes for fire safety did not minimise risk.
- Not all staff had received safeguarding training appropriate to their role.
- A comprehensive infection prevention and control audit had not been conducted for the branch site.
- The practice’s system for ensuring medicines and equipment were checked to ensure they were safe to use were not effective and embedded in practice.
We rated the practice as inadequate for providing effective services because:
- There was limited monitoring of the outcomes of care and treatment.
- The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.
- The practice was unable to show that it always obtained consent to care and treatment.
We rated the practice as inadequate for providing caring services because:
- The practice was unable to evidence the number of carers it identified.
- No actions had been identified to improve low survey results.
We rated the practice as inadequate for providing responsive services because:
- Services did not always meet patient needs.
- Complaints were not always handled in line with their complaints procedure and they were not always used to improve the quality of care.
We rated the practice as inadequate for providing well-led services because:
- The practice culture did not effectively support high quality sustainable care.
- The overall governance arrangements were ineffective.
- The practice did not have clear and effective processes for managing risks, issues and performance.
- The practice did not always act on appropriate and accurate information.
- We saw little evidence of systems and processes for learning, continuous improvement and innovation.
The issues found in effective and responsive affected the rating of all population groups so we rated all population groups as inadequate.
The areas where the provider must make improvements are:
- Ensure care and treatment is provided in a safe way to patients
- Ensure the care and treatment of patients is appropriate, meets their needs and reflects their preferences
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
- Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment
(Please see the specific details on action required at the end of this report).
The areas where the provider should make improvements are:
- Use patient feedback to help drive improvements.
- Identify patients who are carers and provide appropriate support.
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.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice