Archived: Springwell House

Letter from the Chief Inspector of General Practice

We carried out a previous inspection of this practice on 16 April 2015 and found a number of concerns. We rated the practice as requires improvement overall and inadequate in the question ‘Is the practice safe?’ We carried out another inspection on 19 February 2016. The practice had not made sufficient improvements and a continuing breach of legal requirements was found. We placed the practice into special measures, as we continued to rate the practice as inadequate in the question ‘Is the practice safe?’

We undertook this comprehensive inspection to check that the practice had improved and to confirm they now met legal requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Springwell House on our website at www.cqc.org.uk.

Overall, the practice is rated as requires improvement.

Our key findings were as follows:

• The practice had taken action to address the concerns raised during our previous inspection in February 2016. They had addressed the concerns related to cleanliness and infection control and appropriate arrangements were now in place. The practice also now ensured temperature sensitive medicines were stored at appropriate temperatures. Regular checks were made on the oxygen and defibrillator within the practice to make sure they were fit for use in the event of an emergency.
• We found the arrangements for governance and performance management did not always operate effectively. The approach to service delivery and improvement was reactive and focused on short term issues.
• There was a system in place for reporting and recording significant events. Although the practice confirmed they were not aware of any reported significant events within the six months, they were unable to verify this because they had lost access to some key management information, when a member of staff left the practice.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had a system in place for handling complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had a vision to deliver high quality care and promote good outcomes for patients.
• The provider was aware of what they needed to do to demonstrate compliance with the requirements of the duty of candour. However, the practice was unable to give us examples to demonstrate this over the last six months.
• We found there was a limited approach to acting upon the views of people who used service. The practice did encourage feedback from patients and the public. However, they did not use the information they collected to help them improve the quality of service offered.
• At the last inspection in February 2016, we told the provider they should display the latest CQC results within the practice premises. We found these were now prominently displayed.

There were areas where the practice should make improvements. The practice should:-

• Strengthen their governance systems to ensure they are supported to proactively manage and continually improve the quality of the service provided.
• Strengthen their approach to identifying, analysing and learning from complaints, significant events and patient safety alerts to ensure the practice uses these as an opportunity to learn and improve.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a previous announced inspection of this practice on16 April 2015. Breaches of legal requirements were found. Overall, we rated the practice as requires improvement. After the comprehensive inspection the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

• Regulation 15 HSCA (Regulated Activities) Regulations 2014 Premises and equipment

• Regulation 12 HSCA (Regulated Activities) Regulations 2014 Safe care and treatment

• Regulation 10 HSCA (Regulated Activities) Regulations 2014 Dignity and respect

We undertook this comprehensive inspection to check that the practice had followed their plan and to confirm that they now met legal requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Springwell House on our website at www.cqc.org.uk.

Overall, the practice is rated as requires improvement.

Our key findings were as follows:

• The practice had taken action to address most of the concerns raised at the last CQC inspection. They had developed a clear vision, strategy and plan to deliver high quality care and promote good outcomes for patients. However, there were areas where sufficient progress had not been made. This included infection control procedures, medicines management and arrangements to deal with medical emergencies.

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Further improvements were required to how the practice assessed and managed risks.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice had improved their approach to patient confidentiality.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.

• Audits were recorded and used to improve patient care.

• There was a clear leadership structure and staff felt supported by management. The practice had developed a five year business development plan. Staff told us they were aware of the strategy for the practice and felt included and involved in decisions about the future for the practice.

There were areas where the practice must make improvements. The practice must:-

• Improve the arrangements to maintain a clean environment, and assess the risk, detection and prevention of the spread of infections.

• Check the emergency oxygen and defibrillator on a regular basis to ensure they are functioning and ready to use in an emergency.

• Follow best practice guidelines for the management of the cold chain for temperature sensitive medicines.

There were also areas where the practice should make improvements. The practice should:-

• Make sure the practice nurse administered vaccines using directions that were in date and had been produced in line with legal requirements and national guidance.

• Display the results of the latest CQC inspection, including the ratings awarded, prominently within the practice, as well as on the practice website.

I am placing this practice in special measures. Where a practice is rated as inadequate for one of the five key questions or one of the six population groups and after re-inspection has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group, we place it into special measures. This practice has made progress, but the safety domain needs more work therefore we are placing this practice into special measures.

Practices placed in special measures will be inspected again within six months. If insufficient improvements have been made so a rating of inadequate remains 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 varying the terms of their registration within six months if they do not improve.

The practice 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.

Special measures will give people who use the practice the reassurance that the care they get should improve.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice