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Archived: South Ashford Medics Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 20 February 2018

Letter from the Chief Inspector of General Practice

This practice is rated as inadequate overall.

The key questions are rated as:

Are services safe? – inadequate

Are services effective? – requires improvement

Are services caring? – requires improvement

Are services responsive? – inadequate

Are services well-led? - inadequate

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – inadequate

People with long-term conditions – inadequate

Families, children and young people – inadequate

Working age people (including those recently retired and students – inadequate

People whose circumstances may make them vulnerable – inadequate

People experiencing poor mental health (including people with dementia) - inadequate

We carried out an announced comprehensive inspection at South Ashford Medics on 5 December 2017 as part of our inspection programme.

At this inspection we found:

  • The practice had insufficient systems in place to keep patients safe. For example, delays and inconsistencies in the reviewing and actioning of information.
  • They did not ensure the safe management of medicines. For example, the consistent actioning of safety alerts and tracking of prescriptions.
  • Some clinical staff had not received safeguarding or basic life support training.
  • We found the practice to be clean and tidy and an annual infection control audit had been conducted.
  • The practice achieved 98% of the Quality and Outcome Framework points available.
  • The practice recorded, investigated and responded to complaints but did not consistently capture learning to improve the practice.
  • Some of the respondents to the July 2017 GP patient survey reported their experience of the GPs to be below the local and national averages.
  • The practice held regular governance meetings but had failed to identify risks and mitigate them.
  • The GP partners did not operate as a cohesive team. The GP partners concentrated their activities in areas of clinical preference as opposed to ensuring the delivery of safe consistent care.

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:

  • Making patients aware of multi-lingual staff that may support them.

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

Inspection areas

Safe

Inadequate

Updated 20 February 2018

Effective

Requires improvement

Updated 20 February 2018

Caring

Requires improvement

Updated 20 February 2018

Responsive

Inadequate

Updated 20 February 2018

Well-led

Inadequate

Updated 20 February 2018

Checks on specific services

People with long term conditions

Good

Updated 26 November 2015

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multi-disciplinary package of care.

Families, children and young people

Good

Updated 26 November 2015

The practice is rated as good for the care of families, children and young people. There were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children subject to child protection plans. Immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Older people

Good

Updated 26 November 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its patient population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Working age people (including those recently retired and students)

Good

Updated 26 November 2015

The practice is rated as good for the care of working age people (including those recently retired and students). The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to help ensure these were accessible and flexible. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 26 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

The practice provided information to patients experiencing poor mental health about how to access various support groups and voluntary organisations, such as counselling services. It had systems to refer patients to specialist community mental health and crisis intervention services and offered longer appointments to patients experiencing mental health problems. The practice also participated in a scheme to provide primary health care services to patients who had been excluded from other GP practices, due to violence and aggression.

People whose circumstances may make them vulnerable

Good

Updated 26 November 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances, for example, those patients with a learning disability. It had carried out annual health checks and offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. This included co-ordinating and undertaking health care assessments for unaccompanied asylum seeking children for the area. It provided information to vulnerable patients about how to access various support groups and voluntary organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children and were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.