Background to this inspection
Updated
1 May 2020
Ryalls Park Medical Centre – Yeovil is the registered provider of Ryalls Park Medical Centre.
Ryalls Park Medical Centre services are provided from
Marsh Lane
Yeovil
Somerset
BA21 3BA.
The practice delivers services under a general medical service contract to approximately 5,954 patients. The practice is situated in a purpose-built building in a residential area with parking a short distance from Yeovil Hospital.
The practice is registered with the Care Quality Commission to deliver the following regulated activities; Diagnostic and screening procedures; Family planning; Maternity and midwifery services; Surgical procedures and Treatment of disease, disorder or injury.
The practice’s clinical team consists of two GP partners, two salaried GPs, two advanced nurse practitioners, two practice nurses and three health care assistants. They are supported by team of administrators and reception staff as well as a practice manager (registered manager) who is also a partner, an operations manager and two performance managers. The practice is also supported by an additional silent registered partner.
When the practice is not open patients can access treatment via the NHS 111 service.
Updated
1 May 2020
Previously we carried out an announced comprehensive inspection on 1 and 25 July 2019. We served warning notices on the provider for breaches of Regulation 17 Good governance and Regulation 12 Safe care and treatment of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because the quality of care they are responsible for fell below expected standards and legal requirements. Following our inspection in July 2019 the practice was rated as inadequate overall and placed into special measures.
We carried out an announced, focused follow-up inspection at Ryalls Park Medical Centre on 5 November 2019 to confirm that the practice had met the legal requirements in relation to the warning notices served after our previous inspection in July 2019. We found that improvements had been made to address the breaches of Regulation 12 Safe care and treatment. However, not enough had been done to address the breaches identified in the warning notice issued for the breach of Regulation 17 (Good governance). We served a further warning notice to the provider for breaches of regulations 17 Good governance.
We carried out an announced comprehensive follow-up inspection at Ryalls Park Medical Centre on 3 March 2020. This was to follow up on the special measures which had been applied to the practice following our inspection in July 2019. It was also to confirm that the practice had met the legal requirements in relation to the warning notice serviced after our previous inspection in November 2019.
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.
At this inspection we found that improvements had been made to the practice’s systems but not all processes were embedded. We were satisfied that sufficient progress against the warning notice issued for a breach of Regulation 17 (Good Governance) had been made.
This service was placed in special measures in September 2019 in order for the provider to take steps to improve the quality of the services it provided. I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.
We have rated the practice as requires improvement overall.
We found that:
- The practice did not have a system to identify vulnerable adults on their system.
- Systems to conduct disclosure and barring service checks in line with practice policy, were not embedded.
- Systems to act on concerns identified in the infection prevention and control audit, were not embedded.
- The practice did not always hold appropriate emergency medicines.
- Staff did not always have appropriate authorization before administering medicines.
- The practice did not have a formal process to review unplanned admissions or readmissions.
- The practice was unable to demonstrate actions taken to address concerns raised through national patient surveys.
- Appropriate information on how to complain was not always available to patients.
- Processes to support good governance were not fully embedded.
These areas affected all population groups so we have rated all population groups as requires improvement. However, there were areas of positive care.
The areas where the provider must make improvements are:
- Ensure care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
The areas where the provider should make improvements are:
- Continue to identify ways to improve uptake for cervical screening.
- Identify and implement actions to address areas of concern following patient feedback.
- Ensure appropriate information is available for patients who want to complain.
- Ensure staff complete equality and diversity training.
- Continue to monitor and improve outcomes for patients with long-term conditions and mental health conditions.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Rosie Benneyworth
Chief Inspector of PMS and Integrated Care