Dashwood surgery in Ramsgate placed in special measures by Care Quality Commission

Dashwood Medical Centre (image google maps)

Dashwood Medical Centre in Ramsgate has been placed in special measures following an inspection by the Care Quality Commission.

The 5 GP practice, which has around 10,000 patients, was issued two notices for breaches and warned it must ensure care and treatment is provided in a safe way for service users and establish effective systems and processes to ensure good governance.

The report, published this week, says an announced inspection was carried out in November and inspectors rated the service Inadequate overall.

Individual area ratings were inadequate for safety, require improvement for effective services, Good for caring, requires improvement for responsiveness and Inadequate for how the service is led.

A previous inspection in 2017 had found the surgery good overall and in all domains.

Dashwood Medical Centre has already made changes and will be making further improvements.

Inspection report

The inspectors say Dashwood did not have clear systems to keep people safe and safeguarded from abuse and appropriate standards of cleanliness and hygiene were not always met. The practice had systems for the appropriate and safe use of medicines, including medicines optimisation, however, improvements were needed.

The report also noted that the surgery did not always assess patients’ needs and care and treatment were not always delivered in line with current legislation. The practice was also unable to demonstrate that all staff had the skills, knowledge and experience to carry out their roles.

Inspectors added that complaints were not used to improve the quality of care but noted there was compassionate and inclusive leadership, however improvements were needed to ensure the delivery of high-quality sustainable care.

The surgery has been told to improve cervical cancer screening uptake, child immunisation uptake and to use feedback from staff and patients to improve national GP patient survey satisfaction scores.

Inspectors found that 128 patients prescribed medicines used to lower blood pressure had not had the required monitoring tests. A review of 5 records found all needed blood tests. Inspectors could not see evidence that monitoring had been checked prior to issuing prescriptions.

After the inspection the surgery said notes of these patients had been reviewed, learning points had been identified and an action plan had been developed.

Responsive

The inspection found the practice was responsive to the needs of older patients and offered home visits and urgent appointments for those with enhanced needs and complex medical issues and all parents or guardians calling with concerns about a child aged 5 or under were offered a same day appointment when necessary.  The practice also held a register of patients living in vulnerable circumstances including homeless people, Travellers and those with a learning disability.

Recruitment

Staff told inspectors there were insufficient staff employed at the practice and they were currently working on recruiting more. This included producing a “GP attraction package” which shared information during the recruitment process to encourage GPs to work in the local area. The surgery is trying to recruit sufficient GPs to provide an additional 8 sessions per week. They were also attempting to recruit an Advanced Nurse Practitioner, as well as nursing and administrative staff.

Special measures

In the report the lead inspector said: “I am placing this service into 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.”

A spokesperson for the surgery said: “We take the CQC’s findings seriously. We have already made urgent changes and will continue to do so as we bring about the necessary improvements.

“In the meantime, we will continue to provide the best possible care for all our patients.”

26 Comments

  1. Why has it taken 5 years to inspect this surgery??
    When we were patients there the only chance of getting an appointment was queuing from 7am in all weathers otherwise one had no chance. The staff were often off sick and patients were questioned as to what was wrong with them before an appointment could be given. There is no need for appointments it should be a case of walk-in first come first served.

  2. “The surgery has been asked for comment.”

    You’ll be left on hold or trying 300 times to get through on the phone to get a response so good luck.

  3. A structural issue impacting on the service. No one there wants to do a bad job or not cater to the patients needs but 5 GPs between 10000 people is pretty unsustainable. Hopefully this will be the sea change needed to improve things for staff and service users alike.

  4. I have no doubt the doctors and staff tro their best but it’s very demoralising when just 5 part time doctors are trying to deal with 10,000 patient list, all the admin, plus results of test. Kent generally it’s not good for GPs appointments.

  5. left this surgery after they sent me a letter asking to book my diabetic review then when i phoned they said the couldnt make the appointment and i should phone on the day management absolutely terrible and could nt care less

  6. I’ve not been able to get to see a GP since 2019. I did have a check up with a Nurse in 2022, I said how come you will see patients face to face and the Doctors won’t, her answer was, “don’t ask” A useless Surgery and they can strike me off their list if they want to!!

  7. Pretty much the same service at most if not all of our surgeries in Thanet, the biggest problem is the amount of people they’re trying to cater for and with all the new house’s being built, it’ll only get worse.

  8. my granddaughter rang this surgery and told them she would like to see a doctor as she hhad found a lump in her breast. She was told all appointments had gone so try again tomorrow.I took her to Whitstble hospital and she was dealt with in 2 hours. They found more lumps.Treatment was fast and thorough. Then she got the all clear.

  9. There seems to be a huge problem with the delivery of GP services generally. In my local practice, there seems to be no communication between the various services at the practice, nor between the practice and the pharmacy.
    For example, I was (eventually prescribed a course of treatment for a condition. Every so often, I would trudge up the road to get my prescription.
    One day there was none available. I was told by the pharmacy that the prescription was only for 6 months (the surgery hadn’t told me this). The pharmacist said I would need to book a blood test at the surgery.
    So, I trudged off to the surgery. And there the receptionist told me that I should take the blood test after a month had elapsed.
    So, a month later, I trudged (again) to the surgery to book a blood test.
    “Where,” asked the receptionist, “is your form?”
    What form? No one had mentioned a ything about a form that I needed to get (or where to get it from)
    And so it goes on. A serious lack of communication between my health care providers, and an almost impossibility of finding out any important information about my medication regime.

    • Andrew, I share your pain re. blood testing regime. I’ve been having the same regular blood test for over 10 years and my surgery still manages to make it complicated. The mysterious ‘form’ comes up from time to time – it’s not needed, I have no idea what they’re on about. I’d advise trying to book a blood test a month before the 6 month period is up. Phone for results a few days after test (time period varies depending on the type of test). If all is well, you should then be able to take your prescription to the pharmacy and actually get your medication about 3 working days after submitting it. Also a good idea to get a print out of blood test results from surgery so that you know what they’re checking.

    • “There seems to be a huge problem with the delivery of GP services generally.”

      Yeah, a decade and change of ultra libertarian inspired Tory rule. a Tory party who are bankrolled by interests from the USA with huge financial stakes in privatised healthcare and healthcare insurance firms.

      A whole swathe of London GP surgeries have already been sold off.

  10. I was struck off this surgery a few years ago after I reported them to the Care Quality Commission! I had been referred to a consultant who carried out a number of tests, and was called in by the Dashwood COPD nurse to change my inhalers! When she disappeared for a few minutes I sneaked a look at her computer screen, and to my horror discovered the consultant had diagnosed I had two life threatening lung diseases! Her email was six weeks old.

    When the nurse returned I asked her to print off a copy of the Consultants email, and she asked me why I wanted it? She had not made any mention of the lung diseases, just referring to it as COPD! Later I confronted my GP and asked him why were my lung diseases being concealed from me? He said they didn’t have time to ask patients to come in, and have their diagnosis explained to them, Duuurh! Soon after I reported the surgery to the CQC, I was struck off, and had to find another one! I was not a child, I was in my mid 70’s then, and had been swimming a mile every other day for over 20 years, and had been treated by the surgery for “Swimming Induced Asthma”, which it wasn’t! I had Pulmonary Fibrosis, and Emphysema! So folks if your GP says you have COPD, ask them what disease you have, you have right to know!

      • Well Carina, COPD is not a diagnosis, and in my case I had more than one lung disease, both life threatening. Once I knew the surgery was concealing their patients lung disease I contacted 19 medical agencies, including The National Institute for Clinical Excellence (NICE), who “deleted” their definition of COPD to: “At the time of initial diagnostic evaluation….ALL patients SHOULD have:- A chest Radiography to exclude pathologies. A full blood count to identify anaemia or polycythaemeameia. Their BMI calculated. Additional investigations include Sputum Culture should be taken to identify organisms if sputum is persistently present, and purulent. Serial Home Peak Flow Measurements to exclude Asthma, if diagnostic doubt remains. Also ECG and Echocardiogram, and CT scan should be carried out”.

        So, you see, if a GP just says you have COPD after a cursory examination, demand to be referred to a Respiratory Consultant to ascertain a definitive diagnosis of what lung disease you have. Once you have this then you should be prescribed medication for it. There are many different lung diseases, and COPD is just a condition, not a diagnosis! You have a right to know what the D stands for, ie: what lung disease you have!

  11. The problem with surgeries [all around the country] is that there are far too many people presenting themselves with trivial issues.

    The only future is private healthcare! Read that again. If your sitting in a £500+ Thanet house, you can do your bit by releasing some equity to go private. This will take some pressure off the oversubscribed NHS.

    • The future is not private health care.
      Look at the situation in the States. The most expensive system in the world, with the worst outcomes in the Western world.
      And if you have to depend on releasing equity to pay for chronic illness treatment, you very soon won’t have any.
      Again, look at the States.

    • “The only future is private healthcare!”

      Would that be the private healthcare system that is entirely reliant on the nhs for when things go wrong? The same private system that is staffed with the same nhs doctors you’d see in a hospital, working private on their days off?

      If you think £500 would cover anything, you’re a flagrant idiot. A broken arm will run you around £10k, more if needing plates/screws/rehab. Cancer treatment, upwards of £1m…

      Lets not even get into private insurance denying coverage for pre-existing conditions and pushing premiums up once a long term diagnosis is discovered…

  12. Keep building more houses and the stress on all services will surface eventually.

    • Patients should be able to make “Informed” choices, and you can only do this with information. There are a number of charities such as the British Lung Foundation, Action for Pulmonary Fibrosis etc, who can advise on treatment, knowledge is power! For GP’s to conceal a patients diagnoses after being examined by a Respiratory Consultant, is gross negligence in my view!

      • I allege its bs for the most part. Especially after the part where they allegedly stated there were definitions changed because they asked questions. Its pure “targeted individual” kinda vibes.

  13. This surgery was useless pre-Covid then they used Covid as an excuse for the GP’s not to do Face to Face with their patients.

    • “This surgery was useless pre-Covid then they used Covid as an excuse for the GP’s not to do Face to Face with their patients.”

      That was NHS policy nationwide, pal.

  14. Not so sure that GPs are lazy though I can see why frustrated and quite understandably anxious patients can be tempted to come to that conclusion. Seems like all(?) Thanet surgeries are seriously lacking in GPs and if it was a case of good money for lounging around, surely that would not be the case? Trouble is that most surgeries here require more than one extra GP so any potential candidates can look forward to an unmanageable patient list. I reckon most want to do a good job and fear the reality of necessarily failing patients by having to provide sub-standard care.

  15. With the huge national shortage of GPs, hospital doctors & other health care professionals, it’s no wonder surgeries are struggling. So many have left or are leaving. Dubai,NZ , Australia etc offer so much more for their expertise, qualifications, knowledge. Government need to value these people

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