Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection of Mendip Country Practice on 20 September 2016. The practice was rated as requiring improvement for providing safe services; and was rated as good for providing effective, caring, responsive and well-led services. As a result, the practice was given an overall good rating. Following the comprehensive inspection we issued a requirement, due to a breach of Regulation 12 of The Health and Social Care Act (Regulated Activity) Regulations 2014, relating to safe care and treatment.
Within our last inspection report we stated that the provider must:
- Ensure proper and safe management of medicines including arrangements for temperature checks of vaccine storage and action where temperatures are found to be outside the acceptable range.
- Ensure patients are kept safe by staff who had a Disclosure and Barring Service (DBS) check to act as chaperones; and arrangements are understood and consistently applied by all staff.
In addition, we stated that the provider should:
- Review arrangements to assess areas of ‘near misses’ in the dispensary in order to identify trends and take action to prevent, where possible, future occurrences.
- Review health and safety arrangements for use of cryogenic substances.
- Review arrangements to ensure all staff receive regular appraisals.
The full comprehensive report on 20 September 2016 inspection can be found by selecting the ‘all reports’ link for Mendip Country Practice on our website at www.cqc.org.uk.
We undertook a focused follow-up inspection of the practice on 8 August 2017. The inspection was to confirm that the practice had implemented its action plan to meet the legal requirements in relation to the regulatory breaches that we identified in our previous inspection on 20 September 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.
There were key findings across all areas we inspected during this follow-up inspection. We saw documentary and other evidence that:
- The practice had a record of appropriate actions to be taken if vaccine fridge temperatures were outside the acceptable range.
- The practice reviewed its chaperone policy so that only trained staff with a Disclosure and Barring Service (DBS) check would act as patient chaperones. When we spoke to staff who act as chaperones, arrangements were understood and consistently applied.
- The practice monitors and records ‘near misses’ in the dispensary in order to identify trends and take action to prevent future occurrences.
- A Control of Substances Hazardous to Health (CoSHH) risk assessment was in place for cryogenic substances.
- The practice reviewed arrangements to monitor and ensure that all staff received a regular annual appraisal. During our focused follow up inspection, we saw documentary evidence that appraisals for all staff were completed before the end of 2016, or were scheduled for completion in 2017. We saw the practice had a system in place to monitor when appraisals were due.
Following this inspection the practice was rated as good across all domains, and its overall rating remained unchanged.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice