Letter from the Chief Inspector of General Practice
This practice is rated as Inadequate overall. (Previous inspection was on 30 March 2016 and the practice was rated Requires Improvement overall)
The key questions are rated as:
Are services safe? – Inadequate
Are services effective? – Requires Improvement
Are services caring? – Requires Improvement
Are services responsive? – Requires Improvement
Are services well-led? - Inadequate
As part of our inspection process, we also look at the quality of care for specific population groups. The practice was rated as requires improvement for providing caring services and rated inadequate for providing safe, effective, responsive and well-led services. The issues identified as inadequate overall affected all patients, therefore all of the population groups were also rated inadequate:
Older People – Inadequate
People with long-term conditions – Inadequate
Families, children and young people – Inadequate
Working age people (including those retired and students – Inadequate
People whose circumstances may make them vulnerable – Inadequate
People experiencing poor mental health (including people with dementia) - Inadequate
We carried out an announced comprehensive inspection at Dr Isis Neoman also known as St George’s Medical Centre on 15 November 2017 as part of our inspection programme.
At this inspection we found:
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The practice did not have adequate systems in place to keep patients safe and safeguarded from abuse.
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The practice did not have effective systems in place to keep clinicians up to date with current evidence-based practice.
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The practice did not have adequate systems in place to supervise and monitor staff induction and training.
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Results from the July 2017 annual national GP patient survey were mixed in relation to patient satisfaction with the service. Action was not taken to address low patient satisfaction scores.
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The practice did not actively seek patient views about their experience and quality of care and treatment.
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There were inadequate arrangements in place for patients requiring end of life care.
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The practice did not have a system in place for handling complaints and concerns.
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Governance arrangements did not ensure that there were clear and effective processes for managing risks, incidents and performance.
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There was some innovation in relation to improving the service for housebound patients.
The areas where the provider must make improvements as they are in breach of regulations are:
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Ensure care and treatment is provided in a safe way to patients.
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Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
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Establish effective sustems to ensure fit and proper persons are employed.
The areas where the provider should make improvements are:
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Establish a system of identifying and supporting carers.
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Advertise within the practice the provision of translation services for patients.
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Improve processes for making appointments.
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Consider improving communication with patients who have a hearing impairment and review the requirements of Accessible Information Standard (AIS) as per national guidelines.
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.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice