Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at the High Street Surgery on 26 August 2015. The overall rating for the practice was requires improvement. The full comprehensive report on the August 2015 inspection can be found by selecting the ‘all reports’ link for High Street Surgery on our website at www.cqc.org.uk.
After the inspection in August 2015 the practice wrote to us with an action plan outlining how they would make the necessary improvements to comply with the regulations.
The inspection carried out on 28 February 2017 found that the practice had responded to the concerns raised at the August 2015 inspection and had implemented their action plan in order to comply with the requirement notices issued. However, we found other breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The overall rating for the practice remains requires improvement.
Our key findings were as follows:
- The practice did not always maintain appropriate standards of cleanliness and hygiene.
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The practice did not have adequate arrangements to respond to emergencies at the Whitfield Surgery.
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The arrangements for managing medicines, including emergency medicines and vaccines, in the practice did not always minimise risks to patient safety.
- Staff were aware of current evidence based guidance. The practice could demonstrate how they ensured role-specific training and updating for relevant staff.
- Results from the national GP patient survey showed patients felt they were treated with compassion, dignity and respect. However, the practice was below average for its satisfaction scores on consultations with GPs and nurses.
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There was information in the practice leaflet for new patients directing complainants to the practice manager. However, there were no complaints information posters displayed, information published on their website or a complaints leaflet made available.
However, there were also areas of practice where the provider needs to make improvements.
Importantly, the provider must:
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Ensure that the practice has regard to The Health and Social Care Act 2008, Code of practice on the prevention and control of infections and related guidance.
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Revise medicines management processes to help ensure there is a system to monitor blank prescription forms and pads and track them through the practice. Ensure that vaccines are stored appropriately. Ensure staff read, understand and sign standard operating procedures relevant to their role and errors and near misses are consistently reported and discussions take place for staff to learn lessons to reduce further risk.
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Ensure appropriate recruitment checks are undertaken prior to the employment of all staff, including directly employed locum GPs. Ensure all staff are up to date with mandatory training.
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Revise risk management and governance documents to ensure that all risks to patients, staff and visitors are identified and managing in an effective and timely manner. For example, fire risk assessments and evacuation, infection prevention and control, legionella management and responding to medical emergencies.
In addition the provider should:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice