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Ravensbury Park Medical Centre Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 9 October 2019

During a routine inspection

We carried out an unannounced comprehensive inspection at Ravensbury Park Medical Centre on 09 October 2019 as part of our inspection. The practice was inspected in September 2018 and was rated Good.

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 the practice as requires improvement overall.

We have rated all population groups as requires improvement due to concerns with patients’ access to appointments.

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm. However the process for covering staff absence was not always sufficient, there was limited clinical cover.
  • There was evidence of some patients receiving effective care, however, data showed patients with long term conditions did not always receive appropriate care. During the inspection period, the practice sent us data that showed the current outcomes for patients with long term conditions had slightly improved.
  • Some patients reported that the manner of some reception staff did not meet their expectations.
  • Patients reported difficulties accessing appointments at the practice.
  • There were divides within the partnership team and the way the practice was led did not consistently promote a culture or the provision of high-quality, person-centre care and treatment.

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.
  • 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:

  • Maintain a locum pack with sufficient information.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 18 September 2018

During a routine inspection

This practice is rated as Good overall.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Requires improvement

We carried out an announced comprehensive inspection at Ravensbury Park Medical Centre on 11 January 2017, when the service was provided by Dr Titus Keyamo. The overall rating for the practice was inadequate and multiple breaches in regulations were identified. The service was placed in special measures for six months. The practice received input from a number of organisations in this time to assist in improving the quality and the safety of the service.

We carried out an announced follow up comprehensive inspection on 26 September 2017 to review if improvements had been made. We found that whilst some improvements were made, there were insufficient improvements overall, such that the practice remained rated as inadequate and breaches in regulations were identified. Therefore, we took action in line with our enforcement procedures to prevent the provider from operating the service and we began the process to cancel the provider’s registration.

The service was registered under a new provider, Wide Way Surgery, in January 2018, to ensure that practice services could continue to be provided for patients. The practice received input and support to improve and develop the service under this provider. The service provider is now newly registered as Ravensbury Park Medical Centre, and under this arrangement, improvements are still supported by key partners from the previous provider.

This inspection is an announced comprehensive inspection carried out at Ravensbury Park Medical Centre on 18 September 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was carried out in line with our next phase inspection programme.

At this inspection we found:

  • The practice had clear 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.
  • 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.
  • The practice understood the needs of its population and tailored services in response to those needs.
  • Most patients found the appointment system easy to use and reported that they were able to access care when they needed it.
  • There was a renewed focus on continuous learning and improvement, however governance and communication arrangements required a review to ensure quality improvements could be sustained across the organisation.

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:

  • Review and act on performance data, specifically related to patients with high blood pressure, including those with diabetes.
  • Review systems used to identify carers in order to further expand the carers’ register.
  • Monitor the vision for the leadership and management structure to ensure quality can be sustained long-term.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

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