Archived: Abbey Meads Village Centre

We carried out a short notice announced comprehensive inspection at Abbey Meads Medical Centre on 5 June 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected

• information from our ongoing monitoring of data about

services and

• information from the provider, patients, the public and

other organisations.

In September 2018, Abbey Meads Medical Centre began working collaboratively with five other practices in the Swindon area with the support of Integral Medical Holdings (IMH), who provide back-office services such as payroll, human resources, finance and management support. This

collaboration was formed to maintain the services provided by these practices, and to look to develop new ways of working in line with the Government’s plan for primary care, the ‘General Practice Five Year Forward View’.

In March 2019 the practice was registered under a new provider, the Better Health Partnership. This was predominately a business and legal entity change with the same people being responsible for the running of the practice with the previous provider IMH. In May 2019, IMH

withdrew from providing support services, but the structure has remained the same with all correspondence and back office functions being managed at Moredon Medical Centre, which is known as the hub.

We have rated this practice as inadequate overall.

We rated the practice as inadequate for providing safe services because:

• The practice did not have clear systems and processes to keep patients safe.
• The practice did not have appropriate systems in place for the safe management of medicines.
• The practice did not learn and make improvements when things went wrong.

We rated the practice as inadequate for providing effective services because:

• There was limited monitoring of the outcomes of care and treatment.
• The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.

We rated the practice as inadequate for providing responsive services because:

• Patients were unable to access services in a timely manner and there was a lack of continuity of care.

We rated the practice as inadequate for providing well-led services because:

• Leaders could not show that they had the capacity and skills to deliver high quality, sustainable care.
• While the practice had a clear vision, that vision was not supported by a credible strategy.
• The practice culture did not effectively support high quality sustainable care.
• The 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.
• We saw little evidence of systems and processes for learning, continuous improvement and innovation.

These areas affected all population groups so we rated all population groups as inadequate.

We rated the practice as good for providing caring services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

Following the inspection, we applied urgent conditions to the provider registration of the Better Health Partnership, which relates to all five of the providers registered GP practice locations. This was in relation to the significant issues relating to patient safety, the quality of service and leadership and governance.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to 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 by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care