Archived: The Village Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Village Medical Centre on

5 September 2016. Overall the practice is rated as inadequate.

Our key findings across all the areas we inspected were as follows

• Patients were at potential risk of harm because systems and processes were not in place to keep them safe. For example not all appropriate recruitment checks on staff had been undertaken prior to their employment, there had been no risk assessments carried out in relation to health and safety, fire safety, infection control or legionella since 2012, there were no records to show whether staff were immunised against infectious diseases such as Hepatitis B.
• The practice was mostly carpeted including the treatment room used by the practice nurse and no spill kits available.
• There were no clear records to show that staff had received mandatory training such as

safeguarding, infection control, Information Governance or fire safety.

• All reception staff acted as chaperones but had received no formal training and were not DBS checked.
• Staff were not clear about reporting incidents, near misses and concerns and there was no evidence of learning and communication with staff.
• Patient outcomes were hard to identify as no reference had been made to audits or quality improvement for three years and there was no evidence that the practice was comparing its performance to others either locally or nationally.
• The practice had no clear leadership structure, insufficient leadership capacity, no day to day supervision and support of staff and no formal governance arrangements.
• There were no policies and procedures which had been personalised to the practice. There was no repeat prescribing policy available and no policy or process for dealing with safety alerts.
• Patients were positive about their interactions with staff and said they were treated with compassion and dignity.
• The lead GP was working with GP locums due to a difficulty in the recruitment of new partners.

We identified regulatory breaches within the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection . They are Regulation 12 Safe Care and Treatment, Regulation 17 Good Governance, Regulation 18 Staffing and Regulation 19 Fit and Proper Persons.The Care Quality Commission is unable to take enforcement action against the provider regarding these breaches as they are registered with us as a partnership but should be registered as a sole provider. We have made NHS England and the Clinical Commissioning Group aware of this position.

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 service from operating. Special measures will give people who use the service the reassurance that the care they get should improve. The provider must take urgent action to become registered.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice