Following an assessment in June, the Care Quality Commission (CQC) found that Osmaston Surgery on Osmaston Road in Derby was unable to keep patients safe.
The investigation found that the surgery “did not ensure care and treatment was provided in a safe way to patients” and that “the service was not provided in a way to care and respond to patients’ needs”.
Inspectors found that Osmaston Surgery’s systems and processes were ineffective in the management of medicines and that the practice did not have sufficient capacity to deal with the levels of demand of patients.
Inspection findings regarding Osmaston Surgery, Derby
The CQC’s inspection considered categories including whether the service is safe, effective, caring, responsive, and well-led.
Osmaston Surgery was rated as follows:
- Safe: Inadequate
- Effective: Inadequate
- Caring: Requires improvement
- Responsive: Inadequate
- Well-led: Inadequate
During their review of Osmaston Surgery, inspectors found that:
- The service was not provided in a way to care and respond to patients’ needs.
- The practice did not ensure care and treatment was provided in a safe way to patients.
- The practice had not established effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
Some of the most concerning findings were:
- Security arrangements for prescriptions, patient information, and emergency medicines were insufficient.
- Staffing levels were insufficient to meet patients’ needs.
- Clinical meetings and multi-disciplinary meetings were not taking place and there was no clear team approach to holistically review patients at the end of their life, or those with a safeguarding concern.
- Cervical screening rates were below the national target, and the uptake of childhood immunisations was below the minimum target.
- Safeguarding systems required strengthening as they did not provide assurances that vulnerable patients were reviewed regularly to keep them safe.
- Systems and processes were ineffective in the management of medicines.
- The oversight of test results and tasks required strengthening to ensure patients were followed up in a timely manner when necessary.
- Shortfalls were identified with medicine reviews, monitoring patients with long-term conditions to ensure their medications were effective, and the follow-up of patients where a concern had been identified.
- There was ineffective leadership in place.
- Governance processes within the practice required significant strengthening as areas of risk were not being identified and subsequently managed with effective managerial oversight.
- Staff were not up to date with the practice’s mandatory training schedule.
- There was little evidence of systems and processes for learning, continuous improvement, and innovation.
The full report can be found here.
Action taken
As a result of the findings and the considered risk to service users’ life, health, and wellbeing, the CQC decided to issue an urgent notice of decision to impose conditions on the surgery’s registration.
The surgery has been placed in special measures, meaning it will be inspected again in 6 months. If, when inspected again, the surgery is found to have made insufficient improvements such that there remains a rating of inadequate for any of the key questions or overall, the CQC will then take action in line with their enforcement procedures to begin the process of preventing the surgery from providing services.
In a statement, the surgery said:
“We are sorry that over the past few years we have not been able to provide services to the high standard patients rightly expect, which is reflected in CQC inspection reports. We have put in place an improvement plan…and we have worked continually to deliver on that during and since the inspection that took place in June…”
Comment
The level of concern raised by the CQC regarding Osmaston Surgery is deeply worrying. The surgery has had to be placed in special measures and is at risk of closure. This is not without cause.
It is very clear that patients at the surgery have been put at significant risk over a number of years. Patients have been failed and the consequences could be catastrophic for so many.
The surgery must now make leaps to improve before their next inspection or risk being prevented from providing services at all. More importantly, the safety of their patients must also be at the absolute forefront of their attempts to turn things around.
Patients will clearly struggle to put their trust in the service as a result of the worrying level of failures identified by the CQC, and there will be an uphill battle to regain this over the coming months.
How can we help?
Danielle Young is a Legal Director in our Medical Negligence team, which has been ranked in tier one by the independently researched publication, The Legal 500.
If you have any questions in relation to the subjects discussed in this article, then please get in touch with Danielle or another member of the team in Derby, Leicester, or Nottingham on 0800 024 1976 or via our online form.
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