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.”
