Letter from the Chief Inspector of General Practice

This practice is rated as requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Requires improvement

Are services well-led? – Requires improvement

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Requires Improvement

People with long-term conditions – Requires Improvement

Families, children and young people – Requires Improvement

Working age people (including those retired and students – Requires Improvement

People whose circumstances may make them vulnerable – Requires Improvement

People experiencing poor mental health (including people living with dementia) - Requires Improvement

We carried out an announced inspection at Barnsley Healthcare Federation CIC - Lundwood Practice on 13 March 2018 as part of our inspection programme. We also carried out an announced comprehensive inspection at Barnsley Healthcare Federation CIC head office based at Oaks Park Primary Care Centre on 13 and 14 February 2018 to look at governance as part of our inspection programme.

At this inspection we found:

• There was no open and transparent approach to safety and no effective system in place for recording, reporting and learning from significant events.
• The practice did not routinely review the effectiveness and appropriateness of the care it provided. There was limited evidence of audits and quality improvement activities to demonstrate monitoring and assessment of the service was being undertaken since the service registered in July 2016.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients told us through CQC questionnaires, that they felt listened to and supported by staff and had sufficient time during consultations to make an informed decision about the choice of treatment available to them.
• There was a lack of overarching governance arrangements in place that meant patients were not always kept safe from avoidable harm.
• There was a leadership structure but communication between staff and management was limited and some staff felt unsupported by the senior management team.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.

• Ensure governance arrangements are in place to keep patients safe from avoidable harm.
• Ensure that there is an accessible system for identifying, handling. Investigating and responding to complaints made about the service.

The areas where the provider should make improvements are:

• Consider a documented locum induction

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice