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Unsworth Group Practice Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 10 February 2020

On 11 December 2019 we carried out an inspection of Unsworth Group Practice following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a significant change to the quality of care provided since the last inspection.

We inspected the main surgery at Peter House, Captain Lees Road, Westhoughton, Bolton, BL5 3UB. As part of the inspection we also visited the branch surgery at Blackrod Health Centre, Church Street, Blackrod, Bolton, BL6 5EN.

The practice had previously been inspected 17 November 2015. It had been rated good overall and good for each key question except safe, which was rated requires improvement. On 29 December 2016 we carried out a desk top review and received evidence of improvement. We then rated the key question safe good.

This inspection initially focused on the key questions effective and well-led. Because of the assurance received from our review of information we carried forward the ratings for the key questions caring and responsive. During the inspection we opened up the safe key question due to concerns we had found.

We rated the practice inadequate overall with the following key question ratings:

Safe – inadequate

Effective – requires improvement

Well-led – inadequate

The population groups were all rated requires improvement.

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 rated the practice inadequate for providing safe services because:

  • Safeguarding training was not up to date.
  • Clinical records were not always appropriately coded in relation to safeguarding children.
  • Not all the required pre-recruitment information or checks were held.
  • Fire safety and other health and safety checks were not carried out.
  • Appropriate standards of hygiene and infection control were not met.
  • Sepsis training had not been carried out for staff.
  • Patient Group Directions were not adequately managed.
  • Prescription pad security was not managed.
  • Safety alerts were not all actioned in an appropriate or timely manner.
  • The vaccination status of staff, in relation to infectious diseases, was not monitored.

We rated the practice requires improvement for providing effective services because:

  • Staff induction was not consistent.
  • Training was not well-managed; there were gaps in staff training and it was difficult to ascertain what training had been carried out or updated at the appropriate time.
  • Staff appraisals were not up to date.

We rated the practice inadequate for providing well-led services because:

  • There was no overview of the management of the practice.
  • Managers and partners had not identified the gaps in their governance systems.
  • Internal safety audits were either not taking place or not adequate.
  • Performance issues had not been identified.

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.
  • Ensure persons employed by the service provider are of good character, have the qualifications, competence, skills and experience which are necessary for the work to be performed by them, have all the information required under Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and are registered with the relevant professional body.

In addition, the provider should:

  • Develop all-staff meetings to improve communications within the practice.

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

Effective

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