This practice is rated as inadequate overall.

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Requires Improvement

Are services well-led? - Inadequate

This provider registered with CQC to provide the service on 27 November 2017. The service was inspected under the previous provider in November 2015 at which time it was rated good. We carried out an announced comprehensive inspection at Churchwood Medical Practice on 13 November 2018. This was the first inspection since their new registration and was carried out due to concerns raised.

At this inspection we found:

• Pre-employment checks undertaken by the practice were not thorough.
• 78% of patients had not received a medication review that required this.
• The practice overarching governance framework was not effective and did not support the practice to identify and act upon areas for improvement.
• The practice did not have a functioning patient participation group.
• The lack of leadership and oversight in the practice resulted in ineffective systems to identify and proactively manage risks and issues.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

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.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure that staff receive appropriate support, training professional development, supervision and appraisal as is necessary to carry out the duties they are employed to perform.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice