This practice is rated as inadequate overall. (Previous inspection October 2014 – Good)
The key questions are rated as:
Are services safe? – Inadequate
Are services effective? – Requires improvement
Are services caring? – Good
Are services responsive? – Requires improvement
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 The Lakes Medical Practice on 5 January 2018 as part of our inspection programme.
At this inspection we found:
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The practice did not have clear systems and processes in place. Policies were not easily accessible to staff.
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The practice did not have a system in place to deal with patient safety and medicine alerts.
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There was a lack of record keeping within the practice; meetings were not always documented and safety checks were not recorded.
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The practice acted on significant events and took action to make improvements. Staff were aware of their own responsibilities in reporting events.
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Recruitment checks were not always carried out on staff, and staff files did not always contain the relevant information as set out in schedule three of the regulations.
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Safeguarding procedures were in place and staff understood the signs of abuse and how to report any concerns.
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The practice had systems to monitor performance of the practice and were achieving a quality and outcome framework (QOF) score of 85%.
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The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
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Staff involved and treated patients with compassion, kindness, dignity and respect.
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Patients told us they did not find the appointment system easy to use and sometimes struggled getting an appointment
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 in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
- Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
The areas where the provider should make improvements are:
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