Lakeside Healthcare Stamford receives another poor CQC report
A reinspection of Lakeside Healthcare's GP services in Stamford has found the practice still requires improvement and that services are 'unsafe'.
The report has been published following a visit to the Sheepmarket Surgery and St Mary's Medical Centre by the Care Quality Commission on behalf of the Government in March.
While the overall rating for the practice has got better - it has moved from 'Inadequate' to 'Requires Improvement' - patient services were still deemed to be inadequate.
The report states:
- The practice had carried out a significant amount of work to improve the service since the last inspection
- The practice still did not have all the effective systems in place for the appropriate and safe use of medicines, including medicines optimisation
- We were not provided with assurance that sufficient systems and oversight were in place to ensure the dispensaries were adequately and safely managed
- The process in place for medication reviews and the monitoring of long term conditions was still not effective
- Appropriate standards of cleanliness and hygiene were not always met
- There were still gaps in systems to assess, monitor and manage risks to patient safety
- The practice organised and delivered services to meet patients’ needs, although work continued to improve patient experience
- Leaders demonstrated that they had the capacity and skills, but further work was required to embed systems and processes in order for them to deliver high quality sustainable care
- Most governance arrangements were now in place, but further work was required to embed these systems and to ensure they were managed effectively.
One area to receive criticism was the system of reviewing patients' medication to ensure it is suitable and safe.
The CQC inspector reported: "We saw evidence that the code ‘medication review’ was being added to patients' records in line with the surgery policy.
"However, we also saw evidence where this code had been added and the record did not appear to consider or address all the potential concerns with the treatments prescribed."
She added that there was no audit process in place to provide reassurance that an appropriate review had been undertaken and that for seven out of 11 notes examined there was no documentation to say patients’ medicines were still suitable, working and not having adverse side effects.
These included antidepressants, diabetic medicines, and those to reduce stomach acid, as well as medicines which national guidance advises they shouldn't be given together.
Urgent action to be taken by Lakeside Stamford relates, in part, to its dispensary.
The new CQC report states: "During the inspection, staff told us that there were numerous times where there was not adequate staff cover within the dispensaries for medicines to be dispensed safely, due to staff sickness and annual leave."
The inspector also found two breaches of regulations, and the practice has been told it will remain in 'special measures' for a further six months and must:
- Ensure care and treatment is provided in a safe way to patients
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
The report summary concludes: "The service will be kept under review and if needed could be escalated to further 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."
Closure of the service after six months had been suggested by the CQC if there was not significant improvement after its poor report last summer.
Responding to the latest report, Lakeside Stamford hub manager, Teri White, who was recruited as part of an ongoing improvement strategy, said: “As a team we are determined to get Lakeside Healthcare at Stamford to where it needs to be for our patients and stakeholders and have a positive relationship with our Patient Participation Group.
“We have made significant changes since the previous inspection, including employing more staff, restructuring our teams, introducing new management and upgrading our telephone system.
"We also deployed staff proactively to deal with areas of greatest demand and installed a new online consultation system, which is accessible out of surgery hours.
"This raft of measures was all aimed at improving administrative and clinical capacity and increasing access for patients, at a time of huge demand.
“Although we have carried out a massive amount of work in a relatively short space of time, as recognised in this report, we acknowledge that more needs to be done and so will carefully prioritise and tackle the actions identified by the CQC.
“I would like to thank my colleagues for their commitment and dedication. They have worked tirelessly, under constant pressure, and will continue to do so.
"Our team is realistic about the improvements we have implemented so far, but also about the continuing challenges that we are all working hard to resolve.”
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