A South London GP surgery with around 17,600 patients has been rated ‘inadequate’ by the health watchdog in a damning report. The Groves Medical Centre, in New Malden, has been placed in special measures and must make urgent improvements following an inspection by the Care Quality Commission (CQC).
The inspection in October and November found gaps in systems meant to keep patients safe at the practice on Clarence Avenue, including training and medicines management, along with leaders lacking effective oversight of the service. It found leaders had a clear vision to improve the practice, but they had not properly risk-assessed strategies to achieve this or closely monitored their introduction – including poorly overseeing the expanded use of advanced clinical roles and the risks associated with a new online triage service.
Inspectors also found the practice had not properly considered the needs of patients who found it hard to access services and it could not always show staff had the skills and experience to carry out their roles. They said patients’ needs were not always assessed, their care was not always delivered following current legislation and complaints were not consistently dealt with in line with national guidance.
The Groves Medical Centre told the Local Democracy Reporting Service (LDRS) it took “swift action” to put in place new systems and processes responding to the CQC’s concerns following the inspection, and to recruit and train staff.
A report by the CQC, published on April 4, said arrangements to prevent and control the spread of infections were not effective at the practice, with no record of infection prevention and control training for six clinical staff, and that it had not ensured staff had immunity to diseases in line with national guidance. Inspectors found one clinical staff member had no record in basic life support training, along with two out-of-date oxygen masks, three out-of-date airways tubes and a privacy curtain that was installed in 2019 despite policy stating the curtains were replaced at least every two years.
The report also raised concerns about management of medicines at the practice. A clinical search identified 171 out of 443 patients taking medicines that may require another medicine to be prescribed to reduce the risk of damage to the stomach lining, who had not been prescribed the second medicine. Inspectors sampled five of these patients and found one should have been prescribed the second medicine.
Another clinical search indicated 24 patients taking medicines that are sometimes prescribed for high blood pressure or heart failure had not received required monitoring. Inspectors also found some patients with asthma, chronic kidney disease, hypothyroidism and diabetes were not monitored and reviewed in line with national guidance.
Staff, however, gave positive feedback about working at the practice. They reported feeling well-supported and described the culture as positive, with friendly and helpful colleagues.
The CQC’s findings mean the practice’s overall rating has dropped from ‘good’ to ‘inadequate’. It is now in special measures, meaning it will be kept under review and inspected again within six months to check it has improved. The CQC also issued two warning notices relating to patient safety and management of the practice, which require it to make urgent improvements.
A spokesperson for The Groves Medical Centre said: “The CQC inspected the practice five months ago, since then we have taken swift action to put new systems and processes in place, and recruit and train our staff. For example, we have recruited a new clinical safety officer to support how we prioritise patients through our digital system, we have already improved how we document around medication, and we have new ways of learning and sharing information between clinical colleagues. We will continue to work through our action plan, with advice and involvement from our Patient Participation Group, and look forward to the next inspection so that we can regain our ‘good’ rating.”
Image: Groves Medical Centre, Clarence Avenue, New Malden. Credit: Google Maps
