We carried out an unannounced focused inspection at The Drive Surgery on 11 October 2021. Overall, the practice is rated as inadequate.
The ratings for each key question are as follows:-
Safe - Inadequate
Effective – Requires improvement
Well-led - Inadequate
The practice was previously inspected in August 2019.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Drive Surgery on our website at www.cqc.org.uk
Why we carried out this inspection
This inspection was an unannounced focused inspection as a result of concerns relating to the quality of care and leadership at this location.
How we carried out the inspection
Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.
Due to the nature of this inspection, the inspection team was on site for the duration of the inspection.
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 have rated this practice as inadequate overall.
We found that:
- The practice did not have adequate infection prevention controls in place to reduce the spread of infection.
- There were ineffective processes in place for record keeping including significant events.
- The practice had limited evidence of quality improvement activities.
- Checks to ensure staff working at the practice had the relevant qualifications and training not been conducted consistently and in a timely manner.
- The practice was unable to provide evidence to show that there were regular clinical and all staff practice meetings.
- Staff did not always have the appropriate authorisations in place to administer medicines.
- There was a lack of effective processes in place to manage risk and potential issues at the practice.
- The management of medicines at the practice did not always the guarantee the safety of these medicines.
- There was no evidence of learning gained shared within the practice.
The areas where the provider must make improvements:-
- Ensure that care and treatment is provided in a safe way.
- Establish effective care systems and process to ensure good governance in accordance with the fundamental standards of care.
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 a 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