Archived: Eldene Surgery

Updated 2 July 2019

The provider, Better Health Partnership LP, delivers regulated activities from its five main locations (and two branch locations). The addresses for these main sites are:

Moredon Medical Centre

Moredon Road,

Swindon.

SN2 2JG

Tel: 01793 342000

Eldene Surgery

Colingsmead,

Swindon

SN3 3TQ

Tel: 01793 522710

Phoenix Surgery

Dunwich Drive,

Swindon

SN5 8SX

Tel: 01793 600440

Taw Hill Medical Centre

Aiken Rd,

Swindon

SN25 1UH

Tel: 01793 709500

Abbey Meads Medical Group

Village Centre,

Elstree Way,

Swindon

SN25 4YZ

Tel: 01793 706030

We inspected the location Eldene Surgery and visited the hub based at Moredon Medical Centre on 16 April 2019 to see how this part of the service linked with Eldene Surgery. It is one of the practices within the NHS Swindon Clinical Commissioning Group and has approximately 7,800 patients. Data from Public Health England shows that the practice has a similar to local and national figures for all age groups. This data also shows that that 8% of the population within the area are of unemployed status compared to a local figure of 4% and a national figure of 5%. The practice has a relatively high proportion (10%) of patients who have English as a second language.

The practice has a General Medical Services contract to deliver health care services. This contract acts as the basis for arrangements between Swindon Clinical Commissioning group and the practice for the provision of medical services.

Eldene Surgery provides the following regulated activities:

• Treatment of disease, disorder or injury
• Diagnostic and screening procedures
• Maternity and midwifery services
• Surgical procedures
• Family planning

The practice has opted out of providing an out-of-hours service. However, the provider is available outside usual surgery hours, with the practice’s phone line being routed to an answering service, which will pass on messages. Otherwise, patients calling the practice when it is closed relate to the local out-of-hours service provider via NHS 111.

Updated 2 July 2019

In September 2018, Eldene Surgery began working collaboratively with five other practices in the Swindon area with the support of Integral Medical Holdings (IMH), who provide back-office services such as payroll, Human Resources, finance and management support. This collaboration was formed to maintain the services provided by these practices, and to look to develop new ways of working in line with the Government’s plan for primary care, the ‘General Practice Five Year Forward View’. The group is now known as the Better Health Partnership following a change of registration with CQC in March 2019. This was predominately a business and legal entity change with the same people being responsible for the running of the practice with the old provider IMH.

We carried out an announced comprehensive inspection at Eldene Surgery on 17 April 2019. We also received concerns raised by the public and other sources in relation to accessing the service by telephone and for appointments. We also received information that suggested a backlog of administration tasks and correspondence were impacting upon patient care.

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.

We rated the practice as inadequate for providing safe services because:

• The practice did not have clear systems and processes to keep patients safe.
• Receptionists had not been given guidance on identifying deteriorating or acutely unwell patients. They were not aware of actions to take in respect of such patients.
• The practice did not have appropriate systems in place for the safe management of medicines.
• The practice did demonstrate fully how they learnt and made improvements when things went wrong.

We rated the practice as inadequate for providing effective services because:

• There was limited monitoring of the outcomes of care and treatment.
• The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.

We rated the practice as inadequate for providing responsive services because:

• Patients were unable to access services in a timely manner and there was a lack of continuity of care.

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

• Leaders could not show that they had the capacity and skills to deliver high quality, sustainable care.
• While the practice had a clear vision, that vision was not supported by a credible strategy.
• The practice culture did not effectively support high quality sustainable care.
• The overall governance arrangements were ineffective.
• The practice did not have clear and effective processes for managing risks, issues and performance.
• The practice did not always act on appropriate and accurate information.
• We saw little evidence of systems and processes for learning, continuous improvement and innovation.

These areas affected all population groups; therefore, all population groups were rated as inadequate.

We rated the practice as good for providing caring services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

The areas where the provider must make improvements are:

• Ensure that care and treatment is provided in a safe way.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provide should make improvements are:

• Review arrangements for accepting Disclosure and Barring Service checks form previous employers
• Review arrangements for using family members as interpreters.

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

Updated 2 July 2019

Updated 2 July 2019

Updated 2 July 2019

Updated 2 July 2019

Updated 2 July 2019

Updated 2 July 2019