The Care Quality Commission
  • Doctor
  • GP practice

The Old Dispensary

Overall: Good read more about inspection ratings

32 East Borough, Wimborne, Dorset, BH21 1PL (01202) 880786

Provided and run by:
The Old Dispensary

Important: The provider of this service changed. See old profile

All Inspections

30th August 2023

During an inspection looking at part of the service

We carried out an announced focused follow up inspection at The Old Dispensary on 22-30 August 2023.

Since the last inspection, the practice has merged with The Quarter Jack Surgery as a location of that practice. Overall, the practice is rated as good.

Safe - good

Effective – Requires improvement

Caring – not inspected

Responsive -good

Well-led - good

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 Old Dispensary on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up on breaches of regulation and enforcement action from the previous inspections.

On 3 August 2022, when we completed a comprehensive inspection, the practice was rated overall as inadequate. The service was issued urgent conditions on the provider’s CQC registration and placed into special measures.

A further focused inspection was undertaken on 15 November 2022 to assess if improvements had been made in accordance with the provider’s action plan. The practice demonstrated some improvements, but in line with our methodology, the ratings did not change, and warning notices were served under Regulations 12 and 17 of the Health and Social Care Act.

In April 2023, The Old Dispensary merged with another local practice, The Quarter Jack Surgery and the medical, nursing, and administrative workforce joined to support both practices. At this inspection we recognised the work undertaken to meet the enforcement actions and will continue to monitor the areas of effective that require further embedding

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing.
  • 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.
  • A short site visit.

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 had clear systems and processes to keep people safe and safeguarded from abuse. Staff had the information they needed to deliver safe care and treatment, and the practice learned and made improvements when things went wrong.
  • There were adequate systems to assess, monitor and manage risks to patient safety, and appropriate standards of cleanliness and hygiene were met.
  • The practice had systems for the appropriate and safe use of medicines.
  • Patients’ needs were assessed, and care and treatment were delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools. The practice had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.
  • The practice obtained and recorded consent to care and treatment in line with legislation and guidance.
  • People were able to access care and treatment in a timely way. The practice organised and delivered services to meet patients’ needs.
  • Complaints were listened to and responded to and used to improve the quality of care.
  • There was effective leadership at all levels. Leaders demonstrated they had the capacity and skills to deliver high quality sustainable care. The practice had a clear vision to provide high quality sustainable care and had a culture which drove high quality sustainable care.
  • There were clear responsibilities, roles, and systems of accountability to support good governance and management and clear and effective processes for managing risks, issues and performance.
  • The practice involved staff and external partners to sustain high quality and sustainable care. There were systems and processes for learning, continuous improvement and innovation.

Whilst we found no breaches of regulations, the provider should:

  • Consider the use of steroid cards as appropriate to support patients’ needs.
  • Continue working to review all patients in line with your timeline.

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

15 November 2022

During a routine inspection

We carried out an announced focused follow up inspection at The Old Dispensary on 15 November 2022.

This inspection was undertaken because on 3 August 2022 we completed a comprehensive inspection where the practice was rated overall as inadequate. The service was issued urgent conditions on the provider’s registration with CQC and placed into special measures.

This focused inspection was undertaken to assess if improvements had been made in accordance with the provider’s action plan and the urgent conditions placed on their registration. The practice demonstrated some improvements but in line with our methodology, the ratings have not changed.

Following the inspection on 15 November 2022 the ratings remain:

Safe - Inadequate

Effective – Inadequate

Caring - Good

Responsive – Requires Improvement

Well-led - Inadequate

The practice registered with CQC as a partnership 12 June 2019 and was last inspected 3 August 2022.

Why we carried out this inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, considering the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using video conferencing facilities.
  • Speaking with staff during the visit to the practice.
  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • A site visit.

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.
  • Information from the provider, patients, the public and other organisations.

We found that:

  • The provider was able to demonstrate some improvements, however the new systems and processes implemented since our inspection in August 2022, required further embedding to ensure patients received the appropriate reviews and treatment to meet their needs.
  • Clear clinical oversight was needed to ensure all aspects of patient monitoring and review were completed. These included medicine reviews and reviews of patients with long-term conditions.
  • Systems for receiving electronic documents from other services had been addressed and staff had the information they needed to support safe care and treatment.
  • Systems for nursing staff to use a selection of Patient Group Directions (PGDs) to administer some previously agreed specific medicines had been updated and now followed the legal framework.
  • The storage and monitoring of emergency medicines had improved and was safely managed.
  • There was limited monitoring of the outcomes of care and treatment. Patients’ needs were not always assessed, and care and treatment were not always delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools.
  • The practice was unable to demonstrate staff had the skills, knowledge and experience to carry out their roles. Staff were not consistent and proactive in helping patients live healthier lives and the practice was unable to demonstrate it always obtained consent to care and treatment in line with legislation and guidance.
  • Leaders could not demonstrate they had the capacity and skills to deliver high quality sustainable care. The overall governance arrangements required more clinical oversight and support to ensure safe, effective care and treatment was being delivered to patients.
  • The practice did not have embedded and effective processes for managing risks, issues and performance. However the practice had a clear vision and credible strategy and involved the public, staff and external partners.

We found two 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.

Whilst we found no breaches of regulations, the provider should:

  • Continue with the programme of coverage of women eligible to be screened for cervical cancer.

Consider the development of an active Patient Participation Group (PPG)

Following the inspection in August 2022, we undertook enforcement action against the provider, The Old Dispensary.

We placed 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 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 Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

03 August 2022

During a routine inspection

We carried out an announced inspection at The Old Dispensary on 3 August 2022. Overall, the practice is rated as inadequate;

Safe - Inadequate

Effective – Inadequate

Caring - Good

Responsive – Requires Improvement

Well-led - Inadequate

The practice registered with CQC as a partnership on 12 June 2019 and has not been inspected since then.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Old Dispensary Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, considering the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using video conferencing facilities.
  • Speaking with staff during the visit to the practice.
  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A staff questionnaire.
  • A site visit.

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.
  • Information from the provider, patients, the public and other organisations.

We have rated this practice as Inadequate overall

We found that:

  • Staff did not always have the information they needed to deliver safe care and treatment. Patients’ needs were not always assessed, and care and treatment were not always delivered in line with current legislation. Standards and evidence-based guidance were not supported by clear pathways and tools.
  • The practice did not have consistent systems for the appropriate and safe use of medicines, which included medicines optimisation.
  • There was monitoring of the outcomes of care and treatment, but not all audits provided the assurance needed.
  • Staff were not always consistent and proactive in helping patients to live healthier lives.
  • The practice was unable to demonstrate that it always obtained consent to care and treatment in line with legislation and guidance. The practice could not show how it shared learning and made improvements when things went wrong.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way. However, learning from complaints was not well managed
  • Staff dealt with patients with kindness and respect and appropriate standards of cleanliness and hygiene were met.
  • Leaders could not consistently demonstrate that they had the capacity and skills to deliver high quality sustainable care. The practice had a clear vision, but it was not supported by a credible strategy to provide high quality sustainable care. Aspects of the practice culture supported sustainable care.
  • The overall governance arrangements were ineffective and the practice did not have clear and effective processes for managing risks, issues and performance.
  • There was some evidence of systems and processes for learning, continuous improvement and innovation.

We found two 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.

The provider should also:

  • Continue with the programme of coverage for women eligible to be screened for cervical cancer.
  • Consider the development of an active Patient Participation Group (PPG)

Following this inspection, we undertook enforcement action against the provider, The Old Dispensary.

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 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 Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services