THE findings of inspectors which led to a Dorset GP surgery being placed into special measures have been revealed.

The Old Dispensary in East Borough, Wimborne, was rated inadequate by the Care Quality Commission (CQC).

Inspectors from the regulator visited the practice in early August, however, the outcome of the critical visit were only published on October 13.

With the full inspection report now published, more details on the issues found can now be reported.

Alongside the overall practice rating of inadequate, across the five key areas of service the surgery was rated as:

  • Safe – inadequate
  • Effective – inadequate
  • Caring – good
  • Responsive – requires improvement
  • Well-led – inadequate

The practice registered with the CQC as a partnership in June 2019, and this was its first inspection.

How was the inspection carried out?

Inspectors based their judgement on the quality of care at the practice on a combination of what they found when they visited, information from their ongoing monitoring of data about services and information from the provider, patients, public and other organisations.

Sources of gaining information included:

  • Conducting staff interviews using video conferencing facilities.
  • Speaking with staff during the visit to the practice.
  • 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 staff questionnaire.
  • A site visit.

What was found by inspectors?

  • Staff did not always have the information they needed to deliver safe care and treatment. Patients’ needs were not always assessed, and care and treatment were not always delivered in line with current legislation. Standards and evidence-based guidance were not supported by clear pathways and tools.
  • The practice did not have consistent systems for the appropriate and safe use of medicines, which included medicines optimisation.
  • There was monitoring of the outcomes of care and treatment, but not all audits provided the assurance needed.
  • Staff were not always consistent and proactive in helping patients to live healthier lives.
  • The practice was unable to demonstrate that it always obtained consent to care and treatment in line with legislation and guidance. The practice could not show how it shared learning and made improvements when things went wrong.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way. However, learning from complaints was not well managed.
  • Staff dealt with patients with kindness and respect and appropriate standards of cleanliness and hygiene were met.
  • Leaders could not consistently demonstrate that they had the capacity and skills to deliver high quality sustainable care. The practice had a clear vision, but it was not supported by a credible strategy to provide high quality sustainable care. Aspects of the practice culture supported sustainable care.
  • The overall governance arrangements were ineffective and the practice did not have clear and effective processes for managing risks, issues and performance.
  • There was some evidence of systems and processes for learning, continuous improvement and innovation.

Two breaches of regulations were found The CQC said the provider must ensure care and treatment is provided in a safe way to patients and establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The practice was advised it should also continue with the programme of coverage for women eligible to be screened for cervical cancer and consider the development of an active Patient Participation Group (PPG).

What now for the surgery?

A conclusion from Dr Sean O’Kelly, chief inspector of hospitals and interim chief inspector of primary medical services, said: “Following this inspection, we undertook enforcement action against the provider, The Old Dispensary.

“I am placing this service in 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.”

The Daily Echo approached The Old Dispensary following the announcement of the special measures action by the CQC on Thursday, October 13.