Rugby GP practice rated inadequate and placed in special measures by the Care Quality Commission

The Care Quality Commission (CQC) has changed the rating for Central Surgery in Rugby, Warwickshire from good to inadequate, and placed them into special measures following an inspection in December.

Central Surgery provides services from both a main practice and a branch surgery.

This announced inspection was carried out to follow up on concerns CQC had about the quality of care being delivered.

As well as the overall rating for Central Surgery dropping, the ratings for how safe and well-led the service is have dropped from good to inadequate. The ratings for effective and responsive have also declined from requires improvement to inadequate. The rating for caring remains rated as good.

The service is now in special measures which means it will be kept under review, by CQC and re-inspected to check sufficient improvements have been made.

Inspectors found several breaches of regulation during this inspection, and the provider must ensure care and treatment is provided in a safe way to people. As well as establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Sonia Brooks, CQC deputy director of operations in the midlands, said:

“When we visited Central Surgery, we found a decline in how safe and well-led the service was since our last inspection. Behind this was a lack of good leadership which was having an impact in most areas of the practice.

“People’s safety was at risk because leaders didn’t ensure good processes were in place or being followed in a number of key areas. It was particularly worrying that the practice wasn’t regularly reviewing the effectiveness and appropriateness of the care it provided.

“People’s records weren’t good enough to support staff in carrying out medicines reviews which included being able to monitor people who are on high risk medications. In addition, notes from discussions and test results weren’t always recorded.

“Leaders must also look to improve culture at the service, with staff telling us they didn’t feel supported, or feel like they could raise concerns. 

“During our inspection, we found that neither site had the appropriate emergency medication and staff hadn’t been trained in basic life support meaning they may not be able to help someone if they became very unwell.  

“However, despite the issues with leadership and process, we did see staff who were caring and compassionate towards the people they cared for.

“We’ve told the provider where they must make rapid improvements and we’ll continue to monitor it closely to ensure people are safe. If we don’t see these improvements, we will not hesitate to take further action.” 

Inspectors found the following during this inspection:

• Leaders were failing to make sure people were trained appropriately to safeguard children and vulnerable adults
• Staff feedback was negative, and they didn’t feel supported or like they could raise concerns with management
• Learning from significant events and complaints with the service hadn’t been shared with staff
• People’s medical records didn’t reflect discussions or consultations. This included people with long-term conditions
• People’s resuscitation decisions weren’t fully documented
• Staff didn’t have the suitable training for carrying out emergency procedures.

 However, inspectors also found:

• The practice used a clinical tool to identify older people living with moderate or severe frailty and they received a full assessment of their physical, mental and social needs
• People with long-term conditions were offered an annual review to check their health and medicines needs were being met. For people with the most complex needs, the GP worked with other health and care professionals to make sure those needs were met
• Staff were consistently and proactively helping people to live healthier lives.