Westcliff GP Rated Inadequate

THE Care Quality Commission (CQC) has again rated Dr B. Bekas, a GP in Westcliff, inadequate and kept the practice in special measures following an inspection in August last year.

The CQC carried out this inspection to follow up improvements leaders were told to make following their previous inspection, in which CQC rated the practice inadequate due to concerns about people’s safety and the leadership of the practice.

This inspection found sufficient improvements had not been developed or embedded to address these concerns.

The CQC has again rated the practice inadequate overall, and for safe, effective, and well-led. The CQC has again rated the practice requires improvement for responsive. This inspection didn’t assess how caring the service was, so this remains rated as good from a previous inspection.

The CQC has kept the practice in special measures. This means it is being closely monitored to keep people safe and will be inspected again to assess whether it has addressed the issues inspectors identified.

Hazel Roberts, CQC deputy director of operations for the east of England, said: “When we inspected the practice, we were concerned to find leaders still weren’t always acting on risks to people’s safety, including those we raised at our last inspection.

“While staff were doing their best, leaders had failed to support them with good systems and processes to support high quality care.

“Staff didn’t always assess or monitor people’s needs in line with national standards, and we were particularly concerned about care for people with long term conditions or using high-risk medicines.

“For example, we found the practice had potentially missed a diagnosis of diabetes, while other people’s medicines weren’t being reviewed regularly to protect them from side effects.

“Leaders agreed to review care for all people in similar circumstances following our inspection.

“Staff told us they didn’t always have time to monitor people’s treatment and that many colleagues had left the practice in the past year, meaning there were less experienced staff to deliver care.

“A shortage of appointments continued to be an issue at the practice, in part because GP face-to-face appointments were only available six set hours a week. While some appointments had been given to non-GP clinical staff, they told us they’d sometimes been unable to provide care to people with complex needs.

“Leaders didn’t always properly investigate or learn from safety incidents or complaints to protect people in future.

“Staff told us leaders knew about issues, but didn’t always act on them, and some felt unable to implement improvements without fear of retribution from management.

“It’s vital that the leadership team tackle this as a priority and promote an open culture where everyone feels empowered to speak up and be listened to. Staff have important contributions that can help keep people safe.

“While leaders had recently updated many of their policies, staff weren’t familiar with these changes, meaning this had not yet positively impacted people’s care.

“We’ve shared our findings with the management so they know where improvements must be made urgently. We’ll continue to monitor the practice closely to ensure people are kept safe whilst these improvements are made.”

Inspectors also found: GPs weren’t always available on appointment days, causing delays for people’s prescriptions.

Inspectors weren’t assured the practice was identifying people who might need extra support, including through reviews for people with learning disabilities or mental health needs.

Leaders hadn’t acted on gaps in staff training, including around sepsis and safeguarding people from abuse. Staff said high workloads meant training and learning was often deprioritised.

The practice environment remained poor since CQC’s last inspection, impacting people’s safety. The practice had still not been risk assessed for fire or health and safety and lacked a working fire alarm.

 

The local integrated care board had identified some actions needed to reduce people’s risk of infection at the practice, but leaders hadn’t yet done these.

Inspectors couldn’t be assured new staff had the skills needed to care for people safely. Leaders had created an induction programme since CQC’s last inspection, but inspectors didn’t see evidence staff had completed this. There were also continued gaps in recruitment checks.

Staff told inspectors they weren’t always able to discuss people’s treatment with leaders in a timely way, and usually had to rely on email to share information with them.

However: Leaders had implemented a new telephone system and website which made it easier for people to access their services.

The report can be found on CQC’s website.

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