The Care Quality Commission (CQC) has rated Bath Street Medical Centre in Dudley and Dr Mahbub’s Surgery in Walsall, as inadequate and placed them in special measures following inspections in June.
CQC inspected the services, both run by Dr Mahbub, which operates from Bath Street in Sedgley and Brace Street in Walsall, after receiving information of concern about both practices.
The concerns were substantiated and following the inspections, the overall rating for both practices have dropped from good to inadequate.
As well as falling from good to inadequate overall, they have also declined from good to inadequate for being safe, effective, responsive and well-led. Caring has dropped from good to requires improvement.
Following the inspections and due to the serious issues identified, The Black Country Integrated Care Board (ICB), which commissions GP services across the west midlands, has arranged a caretaker provider to run GP services from both practices. Dr Mahbub is not providing care at this time.
Both services are now in special measures, which means they will be kept under close review by CQC to keep people safe and re-inspected to check sufficient improvements have been made.
Andy Brand, CQC deputy director of operation in the midlands, said:
“People weren’t receiving care and treatment meeting standards they had a right to expect at Bath Street Medical Centre and Dr Mahbub’s Surgery. There was a lack of oversight from the provider, and they weren’t aware of the issues both services faced.
“This led to a poor culture, where staff felt undervalued and unsupported, especially when they were understaffed. Also, we found some staff hadn’t received the necessary training to be able to carry out their roles effectively.
“The lead GP was covering both practices, which resulted in delays issuing time sensitive medicines for people. Also, each morning the provider was diverting calls from Dr Mahbub’s Surgery to Bath Street Medical Centre. This increased the volume of calls and people found it difficult to get through to the practice.
“It was concerning that Bath Street didn’t have an effective system to ensure abnormal test results were actioned in a timely way. This placed people at risk of having undiagnosed and untreated conditions.
“At Dr Mahbub’s Surgery we found multiple fit notes left uncollected. One was issued last June but there was no record of the person being seen or requesting the fit note in the first place. We found another five which were uncollected and some expired last year. Also, there was no system in place for managing uncollected prescriptions which could put people at risk of harm.
“Following the inspections and due to the serious failings, we rated both practices inadequate overall and the ICB have brought in a caretaker GP to run the services to ensure people receive safe care.
“We’ll continue to monitor these practices, including through further inspections, to make sure people are receiving the safe care they deserve, and won’t hesitate to take further action if needed.”
In both services, inspectors found:
- Staff did not always have the information they needed to deliver safe care and treatment.
- Safeguarding registers had not been maintained appropriately and the information held was inaccurate.
- There was a lack of oversight of staff carrying out clinical roles, to ensure they were working within their competencies.
- There were significant concerns in the prescribing of medicines, and there were gaps in the information recorded in people’s consultation records.
- There was limited evidence to demonstrate that the practices involved people, staff or stakeholders in developing the services
- The practices were unable to demonstrate that incidents that affect the health, safety and welfare of people using services were reported internally and had been shared with staff to promote learning and improvement.
- Complaints were not always used to improve the quality of care.