Background to this inspection
Updated
16 August 2023
The Osmaston Surgery Centre is located in Derby at:
212 Osmaston Road
Derby
DE23 8JX
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, the treatment of disease, disorder or injury; and surgical procedures. It is not registered to provide maternity and midwifery services which is a requirement of CQC registration for GP practices. No registered manager for the CQC was in post at the time of our inspection, we were informed that 1 of the GP partners was applying to become the registered manager.
The practice offers services from 1 location situated close to Derby city centre. The majority of services are provided from the main building, but the practice also uses an annexe attached to an independent pharmacy at the back of their surgery. This houses some administrative staff and also some consultation rooms.
The Osmaston Surgery is situated within the NHS Derby & Derbyshire Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of approximately 15,350. This is part of a contract held with NHS England. An ICB is a statutory organisation bringing the NHS together locally to improve population health and establish shared strategic priorities within the NHS.
The practice is part of the Derby City North Primary Care Network (PCN) which is a network of 5 local GP practices working collaboratively to deliver improved levels of care for patients, by connecting the primary healthcare team across the area with community and other service providers in their area.
The practice is led by a partnership of 2 GPs. It employs a part-time salaried GP, 4 practice nurses and a phlebotomist. Due to the recent departure of 5 GP partners, the practice was using 5 regular locum GPs and 2 other locum GPs, alongside a team of contracted paramedics and an advanced clinical practitioner to see patients. A GP registrar was also based at the practice.
There was no practice manager in post at the time of our inspection, but there is a clinical services manager and an assistant clinical services manager and a team of reception and administrative staff. The practice also employ 2 cleaning staff who clean non-clinical areas in the practice (a contracted cleaning company clean the clinical rooms).
The practice has access to staff working across their Primary Care Network (PCN) including some additional pharmacy support.
Information published by Public Health England shows that deprivation within the practice population group is in the second lowest decile (2 of 10). The lower the decile, the more deprived the practice population is relative to others.
The practice population age chart indicates a below average number of patients aged 65-79 years old of age, and higher than average number of patients between 25-44 years of age, in comparison to local and national figures.
According to the latest available data, the estimated ethnic make-up of the practice area is 67.1% white, 22.6% Asian, 4.6% Black, and 5.8% mixed and other ethnicities.
The practice is open from 8am until 6.30pm Monday to Friday. Patients can also access appointments until 8pm weekdays and on a Saturday morning through the PCN’s extended access scheme. When the practice is closed, out of hours cover for emergencies is provided via the 111 service.
Updated
16 August 2023
We carried out an unannounced comprehensive inspection at The Osmaston Surgery on 5 June 2023. Overall, the practice is rated as inadequate.
Safe - inadequate
Effective - inadequate
Caring - requires improvement
Responsive - inadequate
Well-led - inadequate
Following our previous inspection on 24 May 2018, the practice was rated good overall and for all key questions.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Osmaston Surgery on our website at www.cqc.org.uk
Why we carried out this inspection.
We carried out this inspection to follow up concerns reported to us.
How we carried out the inspection.
- An unannounced site visit.
- Conducting staff interviews.
- Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
Our findings
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 found that:
- The practice did not ensure care and treatment was provided in a safe way to patients.
- The practice had not established effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- The service was not provided in a way to care and respond to patients’ needs.
We found 2 breaches of regulations. The provider must:
- 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.
In addition, the provide should:
- Review access to appointments and continue to develop sustainable improvements to improve patient experience.
- Improve the uptake of childhood immunisations and cancer screening.
As a result of the inspection team’s findings from the inspection, as to non-compliance, but more seriously, the risk to service users’ life, health and wellbeing, the Commission decided to issue an urgent notice of decision to impose conditions on the provider’s registration. The notice was served on the provider on 13 June 2023 and took immediate effect.
I am placing this service in special measures. Services placed in special measures will be inspected again within 6 months. If insufficient improvements have been made such that there remains a rating of inadequate for any 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 6 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 6 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 Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Health Care