This practice is rated as Good for providing safe services. (Previous inspection May 2018 – Good)

At our last inspection in May 2018 we identified risks related to the monitoring of medicines and other risks related to staff checks and the premises.

At this inspection we found the practice had taken action to mitigate the risks we identified.

The relevant key question is rated as:

Are services safe? – Good

We carried out a focussed follow up inspection at 27 Beaumont Street on 14 December 2018 as part of our inspection programme.

At this inspection we found:

• The practice had systems to monitor patients taking high risk medications.
• Recruitment checks were routinely undertaken.
• There had been improvement to the premises.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection March 2016 – Good)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at 27 Beaumont Street on 22 May 2018 as part of our inspection programme.

At this inspection we found:

• The practice had systems to manage most risks. However, some risks related to premises, recruitment and the prescribing of medicines were not always identified, assessed and mitigated.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
• Care was audited to identify and implement improvements and ensure patients received clinical care in line with relevant guidance.
• Staff involved and treated patients with compassion, kindness, dignity and respect. This was particularly apparent from patient feedback.
• The appointment system was easy to use and patients were able to access care when they needed.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Patients consistently reported positive outcomes regarding the care they received and interactions with staff.
• There was a strong ethos of placing patients at the heart of service planning and delivery and this was reflected in how the service was managed and led.

The areas where the provider must make improvements are:

• Doing all that is reasonably practicable to mitigate the risks to the health and safety of service users including those associated with premises and the proper and safe management of medicines.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

Our previous inspection in September 2015 found breaches of regulations relating to the safe delivery of services.

We found the practice required improvement for the provision of safe services due to concerns identified surrounding medicines management including vaccine storage. The practice was rated good for providing effective, caring, responsive and well-led services. The population groups were rated as good for the patients registered at the practice.

This desk based review was undertaken to check the practice was meeting regulations. For this reason we have only rated the location for the key questions to which these relate. This report should be read in conjunction with the full inspection report of 15 September 2015.

We found the practice had made improvements since our last inspection. During desk based review on the 10 March 2016 we found the practice was meeting the regulations that had previously been breached.

Specifically we found:

• Improvements had been made to maintain a safe system for medicines management including the safe storage and handling of vaccines. For example:
• The practice had developed and implemented a formal written protocol to handle and store vaccines.
• The practice had carried out regular vaccine storage audits and vaccine stock audits.
• Vaccines were safely stored in plastic containers and the fridge temperatures were monitored daily and records maintained.

We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe services.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr HN Hammersley and Partners, 27 Beaumont Street, Oxford, OX1 2NR on 15 September 2015. Overall the practice is rated as good.

Specifically, we found the practice to require improvement for providing safe services. It was good for providing effective, responsive, caring and well led services. The population groups are rated as good for the patients using the practice.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. The majority of information about safety was recorded, monitored and reviewed.
• Risks to patients were assessed and well managed, with the exception of those relating to medicines management, vaccine storage and tracking of prescriptions pads.
• Data showed patient outcomes were good. Audits had been carried out, we saw evidence that audits were driving improvement in performance to improve patient outcomes.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.

• Urgent appointments were usually available on the day they were requested. All patients had a named GP and non-urgent appointments with a named GP were usually available within two days.
• The practice had good facilities and was well equipped to treat patients and meet their needs. However, there was no low level desk at the front reception. This made communication with reception staff difficult for patients in wheelchairs.

• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

The areas where the provider must make improvements are:

• Implement a safe system for medicines management including the safe storage of vaccines.

In addition the provider should:

• Ensure the process for the handling of blank prescription forms are handled in accordance with national guidance as these were not tracked through the practice at all times.
• Carry out a risk assessment for the emergency medicines and determine which emergency medicines should be kept in stock.
• Ensure that within response to complaints patients are given the necessary information of the complainant’s right to escalate the complaint to the Ombudsman if dissatisfied with the response.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice