A medical practice has been placed in special measures and is under threat of closure if it does not improve in the next six months. Chapel Group Medical Centre in Irlam has been ordered to improve patient safety after an inspection judged its overall performance to be "inadequate", following an inspection by the Care Quality Commission (CQC) on May 26.
For safety, leadership and overall its rating was marked as "inadequate", although it was said to be "good" in the caring category. For responsiveness to people's needs and effectiveness it "requires improvement".
Following the inspection, which found three breaches of regulations, the practice was told to ensure care and treatment was provided in a safe way to patients. Complaints received should also be investigated and "any proportionate action taken in response to any failure identified".
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Chapel Group, based on Liverpool Road, must also establish effective systems and processes "to ensure good governance in accordance with the fundamental standards of care". Dr Rosie Benneyworth, chief inspector of primary medical services and integrated care for the CQC, said in her report: "I am placing this service in special measures.
"Services placed in special measures will be inspected again in six months." She said that if "insufficient improvements" have been made after that time enforcement procedures would begin to close the practice down.
"The service will be kept under review and if needed could be escalated to urgent enforcement action," she added. Dr Benneyworth found that recruitment checks were not always carried out in accordance with regulations.
There were gaps in systems to assess, monitor and manage risks to patient safety. Because of a backlog of patient note summarising, staff did not always have the information they needed to deliver safe care and treatment, she said.
The practice did not have effective systems for the appropriate and safe use of medicines, including medicines optimisation and did not have a "clear system to learn and make improvements when things went wrong".
"The practice could not demonstrate how they assured the competence of staff employed in advanced clinical practice," continued Dr Benneyworth. "Patients' needs were not always assessed. There was not an effective system in place for monitoring thyroxine treatment [used for an underactive thyroid gland].
"Patients who had experienced an acute exacerbation of asthma had not always been followed up appropriately." However, Dr Benneyworth said that the staff dealt with patients with "kindness and respect and involved them in decisions about their care".
But complaints were not used to improve the quality of care and there were no clear arrangements to deal with behaviour inconsistent with the practice's vision and values. "Leaders did not always demonstrate an understanding of the challenges to quality of care and identify the actions needed to address these challenges," she said.
"There was no credible strategy to provide high-quality sustainable care and overall governance arrangements were ineffective. The practice did not have clear and effective processes for managing risks, issues and performance.
"The practice did not always act on appropriate and accurate information." Chapel Group is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services, treatment of disease, disorder or injury and surgical procedures.
The practice delivers general medical services to a patient population of about 6,760.
There is a team of four GPs and one advanced clinical practitioner who provide cover at the practice. It has two nurses who provide nurse-led clinics for long-term conditions. The practice has one health care assistant who provides specific clinical procedures, such as blood pressure and new patient checks.
A spokesperson from Chapel Group Medical Centre said: “We are very disappointed with the rating and don’t feel this reflects this practice. We will be looking to work with the CQC to understand how we can get reassessed.
“We put excellent patient care at the heart of our practice and patient feedback has always been very positive. However, we acknowledge there is always room for improvement and continually look for ways to improve.
“We are working with the Royal College of General Practitioners, The LMC, and Salford Integrated Care Partnership to ensure that any issues that need to be addressed are done so appropriately and effectively and want to reassure our patients that we will continue to deliver excellent patient care and their safety is of the upmost importance to us.”
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