11 September 2020
During an inspection looking at part of the service
We carried out an announced focussed inspection (at short notice to the provider) at Sheppey NHS Healthcare Centre on 11 September 2020. The practice was not rated as a consequence of this inspection.
Following the inspection in July 2020 of another location where services were also delivered by the provider DMC Healthcare Limited, we found breaches of regulation and the risk of patient harm. As a result, we took urgent enforcement action and removed that location from the provider’s registration with CQC. This prevented them from continuing to deliver regulated activities at that location. As the provider DMC Healthcare Limited is also delivering regulated activities at Sheppey NHS Healthcare Centre, we carried out this inspection to assure ourselves that the breaches of regulation and risk of patient harm found during the inspection of the other location in July 2020 were not being repeated at this location.
Our judgement of the quality of care at this service is based 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. The on-site inspection activity took place on 11 September 2020 followed by inspection activities carried out remotely the following week.
At this inspection we found:
- The practice had replaced waiting room chairs with those that were covered in materials which were easy to clean.
- All clinical equipment was calibrated regularly in accordance with manufacturers’ guidance.
- The practice’s systems, practices and processes did not always keep people safe.
- Risks to patients, staff and visitors were not always assessed, monitored or managed in an effective manner.
- Staff had the information they needed to deliver safe care and treatment. However, we looked but could not find evidence that the care of all patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD) was based on current best practice guidance (GOLD guidance).
- The arrangements for medicines management helped to keep patients safe.
- Local leadership was well established and worked autonomously as well as independently from overall central leadership provided by staff at the provider’s head office.
- The Registered Manager was not visible in the practice and on-site local clinical supervision was limited.
- Governance arrangements were not always effective.
- The practice involved the public, staff and external partners to help sustain high-quality sustainable care.
- Systems and processes for learning and continuous improvement were not always effective.
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:
- Consider recording the practice’s details on records of regular fire alarm safety tests.
- Consider revising the systems to help keep governance documents up to date.
We are mindful of the impact of COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care
Please refer to the detailed report and the evidence tables for further information.