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Ryalls Park Medical Centre - Yeovil Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 30 September 2019

We carried out an announced comprehensive inspection at Ryalls Park Medical Centre over two days, 1st and 25 July 2019 following an Annual Regulatory Review and as part of our inspection programme, and in response to information received in. We previously inspected this service 28 April 2016 where we rated it Good overall. However, the issues with telephone access were raised as a concern that should have been addressed by the provider following the inspection process.

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, inadequate for safe, effective, responsive and well led and all of the population groups and requires improvement for the area of caring.

We found that:

  • Work was in progress to improve the support provided to patients with long term and mental health conditions.
  • The information about the immunisation status of staff was incomplete to support that staff vaccination was maintained in line with current Public Health England (PHE) guidance.
  • There were gaps in the staff training to meet patients’ needs for long-term conditions, although interim measures were in place until this was achieved.
  • General feedback from patients was staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The difficulties in patient communication with the practice and obtaining an appointment during the last 12 months had resulted in an increased number of complaints but there was evidence this was beginning to settle.
  • The practice had reviewed and put changes in place regarding how it organised and delivered services to meet patients’ needs in response to concerns and feedback. However, it was too early to fully assess that these changes were having a sustained positive impact.
  • Some changes in the practice partnership had affected the way the practice was led and managed and there was now a focus on improving and promoting the delivery of high-quality, person-centre care. However, it was too early to fully assess these changes were effective.
  • The systems for the management of the service records was not well organised but plans were in place to improve how information and records were stored and monitored.
  • The partnership had been slow to amend its registration with the CQC and about the changes in the partnership.

The areas where the provider must make improvements are:

  • Ensure care and treatment is provided in a safe way to patients with an effective programme of monitoring and support to meet their needs.
  • 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:

  • The practice should continue with their actions regarding the necessary Disclosure and Barring checks are in place for staff who undertake chaperone duties.
  • The practice should continue to ensure staff acting as chaperones had the appropriate recruitment checks to guarantee patient safety.
  • Continue with ensuring the actions required following the fire risk assessment are completed in a timely way and that a programme of fire training is sustained.
  • The practice should sustain a programme of revisiting checks for safety alerts for high risk medicines so that patients are not missed from the monitoring systems.
  • The practice should continue to implement its plans for audits so that there is a sustained system in place.
  • The practice should continue to support staff to have the required training to meet the needs of the patients including long term conditions.
  • The practice should continue to proactively identify patients with long-term, mental health conditions and carers to provide them with appropriate support.
  • The practice should continue with improvements in its complaints handling processes so that complainant’s feel they are listened to and that improvements are put in place for communication with secondary care.

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.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection areas

Caring

Requires improvement
Checks on specific services

People with long term conditions

Inadequate

Families, children and young people

Inadequate

Working age people (including those recently retired and students)

Inadequate

People experiencing poor mental health (including people with dementia)

Inadequate

People whose circumstances may make them vulnerable

Inadequate