The Care Quality Commission (CQC) has rated Lanchester Medical Centre in Durham as inadequate overall and placed it into special measures to protect people following an inspection from July to August.
Lanchester Medical Centre, run by Dr Harpreet Singh Kalra, provides services to approximately 4,100 people.
CQC carried out this inspection following concerns received from whistleblowers and people using the practice. It was the first inspection since the service was registered with CQC.
Inspectors found breaches of regulation at this inspection in relation to safe care and treatment, receiving and acting on complaints, as well as good management.
CQC has imposed urgent conditions on its registration to focus its attention on the areas where significant and immediate improvements are needed to keep people safe.
The conditions include sending CQC an action plan to provide assurance on how they will carry out services, as well as sending CQC monthly updates on progress. CQC has also imposed a condition preventing Dr Harpreet Singh Kalra from carrying out services at Lanchester Medical Centre for three months, which will be until Friday 14 November. From 15 November, that condition will be removed.
While the recommended improvements are being made, services are being provided by another organisation. It is fully aware of the concerns identified and has put arrangements in place to make the necessary changes.
Following the inspection, CQC has rated how safe, effective, responsive and well-led the service is as inadequate. Caring has been rated as requires improvement.
CQC has also placed the service into special measures which involves close monitoring to ensure people are safe while they make improvements. Special measures also provide a structured timeframe so services understand when they need to make improvements by, and what action CQC will take if this doesn’t happen.
Victoria Marsden, CQC deputy director of operations in the north said:
“When we inspected Lanchester Medical Centre, we found serious leadership failings that jeopardised people’s safety. Our experience tells us that when a service isn’t well-led, this has a knock-on effect on the level of care being given, which is what we found here.
"Staff told us they were afraid to raise concerns about people’s safety as they felt leaders were unapproachable. Some had experienced bullying, whilst others said colleagues had been threatened when they tried to speak up. This created a toxic culture where serious safety issues could go without being addressed.
“It was concerning that leaders didn't have effective systems and processes in place to manage medicines safely, monitor long-term conditions, or deal with test results appropriately. This meant people were at risk of harm as they could be given the wrong medication or miss important follow-up care due to their results not being managed properly.
“We also heard there were times when the practice was contacting people late at night with their test results. We were told that this was stressful for elderly people as they couldn’t always reach their phone in time, which resulted in them making repeated calls to the practice to find out why they were being contacted.
“Additionally, our inspectors found that it wasn’t always easy to access a GP appointment. Most people were seen by a nurse due to there being no GP available. This meant people were at risk of harm due to them not being seen by appropriately skilled staff.
"However, inspectors recognised that despite these serious failings in leadership and systems, we did receive some positive feedback from people about staff being friendly and helpful.
“We have imposed urgent conditions on the service to drive the rapid improvements needed and will continue to monitor the practice closely to make sure people are safe whilst that happens.”
Inspectors found:
- The practice didn’t have enough qualified, skilled and experienced staff to deliver safe care and treatment to people.
- Leaders didn't have effective systems and processes in place to record and investigate complaints. This meant staff couldn’t learn from incidents and complaints to improve people’s care.
- The practice didn’t ensure that significant events were investigated appropriately. Therefore, staff couldn’t learn from them to help prevent them from reoccurring.
- The service didn’t control the risk of infection to prevent illnesses spreading or share any concerns with appropriate external organisations in a timely manner.
- Leaders didn’t consider the wellbeing of staff, to help them deliver person-centred care. This posed a risk to both staff and the people they were caring for.