Archived: Branston Surgery Also known as The Surgery

Updated 24 February 2023

Station Road

Branston

Lincoln

Lincolnshire

LN4 1LH

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury.

Since our inspection in November 2022 an application to the Care Quality Commission is underway for a new registered provider to take over the practice. The potential new provider has been added to the GP contract and has been working alongside the current registered provider following our inspection in November 2022. At the time of our inspection in January 2023 an onsite operational manager was not in place. However, recruitment was underway, and a manger was due to commence employment by February 2023.

The practice is not a dispensing practice.

The practice is situated within the NHS Lincolnshire Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of about 5,619. This is part of a contract held with NHS England.

The practice is part of a wider network of seven GP practices known South Lincoln Healthcare primary care network (PCN).

Information published by Public Health England shows that deprivation within the practice population group is in the ninth lowest decile (nine of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 98.6% white, 0.7% mixed, 0.4%Asian, 0.2% black.

The age distribution of the practice population closely mirrors the local and national averages. There are more male patients registered at the practice compared to females.

Branston Surgery is a single-handed practice. In addition to the GP owner, there are two salaried GPs. They provide 20 sessions a week in total. The practice has a team of an advanced nurse practitioners, three practice nurses and a phlebotomist. They are supported at the practice by a team of reception and administration staff.

The practice is open between 8 am to 6.30 pm, closing for lunch between 1pm and 2pm Monday to Friday. During the period between 1pm and 2 pm the telephones are answered, and a GP is available. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided locally by the South Lincoln Healthcare Federation, where late evening and weekend appointments are available. Out-of-hours services are provided by the Lincolnshire Community Health Services NHS Trust.

Updated 24 February 2023

We carried out an announced comprehensive at Branston Surgery on 8 November 2022. Overall, the practice is rated as inadequate.

Safe - inadequate.

Effective - requires improvement.

Well-led - inadequate.

Why we carried out this inspection

We carried out this inspection to follow up concerns of regulation from the previous inspection in line with our inspection priorities.

The focus of the inspection was on the key questions of safe, effective and well led and to follow up the breaches of regulations identified during our previous inspection on 9 November 2021 of Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment and Regulation 17 HSCA (RA) Regulations 2014 Good governance,

How we carried out the inspection/review

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 did not always provide care in a way that kept patients safe and protected them from avoidable harm.
• Patients did not always receive effective care and treatment that met their needs.
• The provider did not have effective oversight of the systems and processes designed to deliver safe and effective care.
• Governance systems were ineffective.
• The provider did not have systems and processes in place to identify and manage risk that may affect delivery of safe and effective care,
• Staff did not always have the training and supervision required,

We found four breaches of regulations. The provider must:

• Ensure care and treatment is provided in a safe way to patients,
• Ensure patients are protected from abuse and improper treatment,
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care,
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment,

Due to the failings we identified in the management of patient care and treatment on the announced inspection on 8 November 2022 action was taken to protect the safety and welfare of people using this service’. We issued Warning Notices pursuant to Section 29 of the Health and Social Care Act 2008.

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.