This practice is rated as Good overall. (Previous rating 11 January 2018 – Good). The key question of safe was rated requires improvement.

At this inspection 9 October 2018 we found the practice had implemented changes to rectify concerns found at the previous inspection. The key question of safe at this inspection was rated as: Good

We carried out an announced focused inspection at Beckington Family Practice on 9 October 2018. The reason for this inspection was to follow up on breach of regulation 12, Safe care and treatment regarding medicines management and some areas that we suggested the practice should review for record keeping and the development for health and safety. The practice was previously rated as requires improvement for providing safe services because:

• Good medicines management was not always maintained.

Areas we suggested should be reviewed were:

• The recruitment records did not support the practices recruitment procedure for GPs was followed.
• The systems for monitoring infection control were not embedded.
• The systems for ensuring a safe environment at the Freshford branch surgery was not fully implemented.
• The systems for monitoring that all equipment held and used at the practice locations and on home visits was calibrated and fit for use was not comprehensive.

At this inspection we found:

• Safe medicines management was in place and within the dispensary at Beckington.
• The practice had reviewed the facilities and safety of providing a service from their Freshford branch surgery and found it could not provide a safe sustainable service and had closed this facility. Patients were redirected to the Beckington or Fromefield locations for all aspects of their care.
• The practice had implemented systems to ensure GP recruitment and employment records were stored centrally and now included the information required as set out in the practices own recruitment policy and procedure.
• The significant issues or concerns regarding infection control had been resolved with the closure of the Freshford location. Minor improvements necessary had been implemented at the Beckington and Fromefield locations with a planned programme of audit and review.
• The significant issues or concerns regarding fire safety at Freshford had resolved with the closure of the Freshford location. A review by the provider of Freshford had generated changes to improve the management of fire safety at the other locations.
• The provider had further developed their approach to health and safety and safe systems were in place that protected patients, staff and visitors.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 19/02/2015 – was overall rated as Good). However, during this 2015 inspection we found areas of the practices medicines management that required improvement. We had concerns in regard to:

• Patients and other people were not protected against the risks associated with unsafe or unsuitable storage of medicines and related stationery.

• The content of the emergency medicines kit did not reflect the contents label and treatment guidelines.

• The procedures for the destruction of patients own controlled medicines were in need of review.

• The spare medicines key was not stored safely.

• The processes to support the remote collection of medicines were not safe.

At this inspection:

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

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive at Beckington Family Practice on 11 January 2018. This inspection was carried out as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• 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.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

Patients valued the services provided and the commitment staff gave to providing their care and treatment.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients. The practice must review the arrangements for checking emergency medicines. In the dispensaries the practice must review the use of medicines in their original foil wrapping inserted into the patients prepared weekly blister packs

The areas where the provider should make improvements are:

• The practice should review the systems and documentation for some aspects of medicines management including monitoring all prescription forms, Standard Operating Procedures, expiry date checks, managing safety alerts, and controlled drugs.

• The practice should review how evidence of the recruitment process for GPs is be kept to evidence that the process was carried out in accordance to the practices own policy and procedure.

• The practice should continue with an on-going risk assessment process and take appropriate actions to maintain a safe and accessible service at the Freshford branch surgery.

• Continue with a programme of identifying and supporting carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection at Beckington Family Practice on 4 and 6 November 2014.This included an inspection of the St Luke’s Surgery at Beckington and the inspection of the branch surgeries, at Freshford and Frome.

The provider also holds satellite surgeries in the village halls at Norton St Philip and Rode but we did not visit these locations.

Overall the practice is rated as Good. We found consistently high levels of satisfaction with the services provided.

Our key findings were as follows:

• The practice had responded well to comments in the patient satisfaction survey relating to the appointments system by installing a new digital telephone system and increasing the number of staff available to answer calls in the mornings.

• Patients told us they were treated with kindness and staff maintained their confidentiality.

• The practice worked well with other professionals to meet the needs of patients from the travelling community.

• Governance and performance management arrangements had been proactively reviewed and took account of current models of best practice

We saw several areas of outstanding practice including:

• The practice was able to offer hearing tests. This meant patients who needed to be referred to the Ear, Nose and Throat department at the local hospital could be referred directly rather than being first referred to the hospital audiology department.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure medicines and related controlled stationery are stored securely.
• Review the content of the emergency medicines kit to ensure the contents reflect the contents label and treatment guidelines.

• Review the procedures for the destruction of patients own controlled medicines.

• Review the storage of the spare medicines key.

• Review the processes to support the remote collection of medicines.

In addition the provider should:

• Consider how they ensure that all dispensary staff have been assessed as competent for their role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice