The Care Quality Commission
  • Doctor
  • GP practice

Archived: Polkyth Surgery

Overall: Inadequate read more about inspection ratings

14 Carlyon Road, St. Austell, Cornwall, PL25 4EG (01726) 75555

Provided and run by:
The Park Medical Centre

Important: The provider of this service changed. See new profile

All Inspections

3 November 2015

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Polkyth practice on 22 January 2015 and identified areas where the practice had not complied with regulations. We set three requirement notices, the practice was placed in to Special Measures and our report was published. The practice was given six months to improve.

It is important to note that the practice has undergone a period significant change. Key clinical and management staff have left the practice, and the practice is now one of five that constitute the newly formed consortium known as the St Austell Healthcare Group (SAHG). The SAHG are currently in the process of registering this service with the Care Quality Commission. Following a period of closure, refurbishment and rebranding the practice is now known as the Carlyon Road Health Hub, at which there are no patients registered. Since re-opening on 3 August 2015 the service offered has been redesigned to work in tandem with the other three practices in the group, at which all patients are registered. Carlyon Road provides a ‘health hub’ for responding to patients needing urgent care  on site, and booking appointments at the other practices for patients with less urgent needs.

We undertook this focused inspection on 3 November 2015 to check on the progress of improvements being made. This report covers our findings in relation to the requirements and should be read in conjunction with the report published on 8 May 2015 following our inspection on 22 January 2015, by selecting the 'all reports' link for Polkyth Surgery on our website at www.cqc.org.uk

Our key findings across all the areas we inspected were as follows:

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, systems and processes were still new, thus not yet embedded into practise.
  • A programme of clinical audit had been commenced, but it was too early to see evidence that audits were driving improvement in patient outcomes.
  • The majority of patients said they were treated with compassion, dignity and respect, however, not all felt cared for and supported by the new health hub system.
  • Urgent appointments were available on the day they were requested.
  • The practice had developed a number of new policies and procedures to govern activity.
  • The practice had proactively sought feedback from patients and had an active patient participation group, with whom they regularly engaged.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

  • Undertake significant event reviews and learning must be demonstrated and shared with all staff, to promote improvement.

There were areas where the provider should:-

  • Ensure that the clinical audit system introduced is continued and is focussed on continuous improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

22 January 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We undertook a comprehensive inspection of Polkyth Surgery on 22 January 2015. Polkyth is situated in the town of St Austell and has a patient group of 8300. The practice employs one full time salaried GP with the remaining sessions offering appointments being covered by locum GPs. The practice was rated as inadequate in respect of not being safe, effective or well led; requires improvement for providing effective services and good for being caring. Overall the rating is inadequate.

The practice is currently going through significant change following change of ownership in September 2014. There is only one full time salaried GP with locum GPs working other sessions. The overall responsibility for the practice is held by The Park Surgery, St Austell. The two other GP practices in the town, along with The Park Surgery, have formed a consortium known as the St Austell Healthcare Group Ltd, they have in place an agreement to help manage and lead Polkyth Surgery and support the improvements required.

Our key findings were as follows:

  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. We saw staff treated patients with kindness and respect, and maintained confidentiality.
  • Some patients reported that they did not always see the same GP so did not experience continuity of care. Other patients reported difficulty in obtaining an appointment.
  • Patients were at risk of harm because systems and processes were not in place, risks to safety had not been minimised. The practice had a new designated system in place for reporting, recording and monitoring significant events but these new systems had not yet been embedded into the practice. Medications were not managed safely and test results were not managed in a timely way.
  • The practice did not have a clear vision and strategy. They had experienced severe disruption over the past six months. The GPs from the St Austell Healthcare Group were working with the NHS England local area team to ensure the practice continued to deliver a service. Staff we spoke with were not clear about their responsibilities in relation to the vision or strategy. There was no clear leadership structure in place.

The provider must:

  • identify and monitor the training needs of staff to ensure they have an appropriate training updates and awareness of practice policy in key areas of health provision including; the Mental Capacity Act 2005, equality and diversity and safeguarding vulnerable adults and children, and basic life support.
  • effectively monitor the quality of the service and identify, assess and manage risks to patients and others including; carry out clinical audits cycles; implement a quality assurance system (incorporating patient feedback); implement a system for disseminating alerts and new guidance; ensure staff are clear about lines of accountability; and consistently identify, record and investigate incidents and disseminate learning from significant events to staff.
  • Implement a system to formally review patient’s medicines before prescriptions are given to patients. Prescription pads must be kept secure and GPs must sign all prescriptions before they are given to patients.
  • Nursing staff must receive up to date training in vaccinating adults and children.

In addition the provider should:

  • The Chaperone policy should be made more visible in the practice waiting room and each of the consulting rooms.

On the basis of the ratings given to this practice at this inspection, I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care we will take steps to cancel its registration with CQC.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice