Riverside Practice

We carried out an announced comprehensive inspection at The Riverside Practice on the 9 March 2022. Overall, the practice is rated as Requires Improvement.

We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Cambridgeshire and Peterborough. To understand the experience of GP providers and people who use GP services, we asked a range of questions in relation to urgent and emergency care. The responses we received have been used to inform and support system wide feedback.

Following our previous inspection on 9 December 2016, the practice was rated Good overall and for providing Safe, Effective, Caring Responsive and Well-led services.

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

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.

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
• 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 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 have rated this practice Requires Improvement overall.

Safe – Requires Improvement

Effective – Requires Improvement

Caring – Good

Responsive – Requires Improvement

Well-led - Requires Improvement

We rated the practice requires improvement for providing safe services because:

• The practice did not always manage test results in a timely manner;
• The management of MHRA safety alerts did not consistently include all relevant alerts.
• The practice had met the recommended standards for childhood immunisations.
• The practice did not have a process in place to demonstrate prescribing competencies of non-medical prescribers;
• Systems for the appropriate and safe use of medicines required strengthening;
• The practice learned and made improvements when things went wrong;

We rated the practice requires improvement for effective services because:

• Not all patients with long-term conditions had been offered a structured annual review.
• Uptake rates for the cervical screening programme remained below the national target.
• The practice did not have a programme of targeted quality improvements in place.
• A system to review competencies for all staff was not fully in place.
• Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) decisions were not always reviewed and documented in line with relevant legislation.

We rated the practice good for caring services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• National GP patient survey results were mainly in line with national and local targets.
• Complaints were handled in a timely manner.

We rated the practice requires improvement for responsive services because:

• National GP patient survey results for accessing services had continued to remain below local and national targets.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.

We rated the practice requires improvement for well-led services because:

• There was limited evidence of governance systems and process, in relation to identifying, managing and mitigating risk to patients.
• Not all staff knew and understood the vision, values and strategy of the practice.
• The practice did not have a quality improvement programme in place.
• Leaders and staff working at the practice had a commitment to improve.

We found breaches of regulations, the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure care and treatment is provided in a safe way for service users.

The areas where the provider should continue to make improvement are:

• Evaluate systems and arrangements in place for advanced care planning, end of life care and DNACPR decisions to ensure they are clearly documented and communicated.
• Continue to explore and improve patient access to the service.
• Restart plans to carry out a patient survey and act on feedback.
• Ensure staff understand the vision, values and strategy.

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