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Archived: Ryalls Park Medical Centre - Yeovil Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 1 May 2020

Previously we carried out an announced comprehensive inspection on 1 and 25 July 2019. We served warning notices on the provider for breaches of Regulation 17 Good governance and Regulation 12 Safe care and treatment of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because the quality of care they are responsible for fell below expected standards and legal requirements. Following our inspection in July 2019 the practice was rated as inadequate overall and placed into special measures.

We carried out an announced, focused follow-up inspection at Ryalls Park Medical Centre on 5 November 2019 to confirm that the practice had met the legal requirements in relation to the warning notices served after our previous inspection in July 2019. We found that improvements had been made to address the breaches of Regulation 12 Safe care and treatment. However, not enough had been done to address the breaches identified in the warning notice issued for the breach of Regulation 17 (Good governance). We served a further warning notice to the provider for breaches of regulations 17 Good governance.

We carried out an announced comprehensive follow-up inspection at Ryalls Park Medical Centre on 3 March 2020. This was to follow up on the special measures which had been applied to the practice following our inspection in July 2019. It was also to confirm that the practice had met the legal requirements in relation to the warning notice serviced after our previous inspection in November 2019.

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.

At this inspection we found that improvements had been made to the practice’s systems but not all processes were embedded. We were satisfied that sufficient progress against the warning notice issued for a breach of Regulation 17 (Good Governance) had been made.

This service was placed in special measures in September 2019 in order for the provider to take steps to improve the quality of the services it provided. I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

We have rated the practice as requires improvement overall.

We found that:

  • The practice did not have a system to identify vulnerable adults on their system.
  • Systems to conduct disclosure and barring service checks in line with practice policy, were not embedded.
  • Systems to act on concerns identified in the infection prevention and control audit, were not embedded.
  • The practice did not always hold appropriate emergency medicines.
  • Staff did not always have appropriate authorization before administering medicines.
  • The practice did not have a formal process to review unplanned admissions or readmissions.
  • The practice was unable to demonstrate actions taken to address concerns raised through national patient surveys.
  • Appropriate information on how to complain was not always available to patients.
  • Processes to support good governance were not fully embedded.

These areas affected all population groups so we have rated all population groups as requires improvement. However, there were areas of positive 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:

  • Continue to identify ways to improve uptake for cervical screening.
  • Identify and implement actions to address areas of concern following patient feedback.
  • Ensure appropriate information is available for patients who want to complain.
  • Ensure staff complete equality and diversity training.
  • Continue to monitor and improve outcomes for patients with long-term conditions and mental health conditions.

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

Rosie Benneyworth

Chief Inspector of PMS and Integrated Care

Inspection areas

Safe

Requires improvement

Effective

Requires improvement

Caring

Requires improvement

Responsive

Requires improvement

Well-led

Requires improvement
Checks on specific services

People with long term conditions

Requires improvement

Families, children and young people

Requires improvement

Older people

Requires improvement

Working age people (including those recently retired and students)

Requires improvement

People experiencing poor mental health (including people with dementia)

Requires improvement

People whose circumstances may make them vulnerable

Requires improvement