Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Southville Surgery on 9 February 2016. Following our comprehensive inspection overall the practice was rated as good with requires improvement for the safe domain. Following the inspection we issued a requirement notice. The notice was issued due to a breach of Regulation 12 of The Health and Social Care Act (Regulated Activity) Regulations 2014, Safe care and treatment. The requirement notice was for the practice to implement the necessary changes to ensure patients who used the service were protected against any risks associated with the safe management of the medicines, the checking of emergency equipment and the safe management of blank prescriptions. A copy of the report detailing our findings can be found at www.cqc.org.uk.

Our key findings during this inspection were as follows:

The areas where the provider must make improvement were:

• The medicine management policy was not fully implemented which impacted on the safe management of medicines by the practice specifically key security, storage of controlled medicines, ensuring patient medicines were returned to the pharmacy and ensuring regular checks of the stock kept in the practice.

The areas where the provider should make improvement were:

• The practice should ensure they undertake checks through the Disclosure and Barring Service for personnel employed to carry on the regulated activities.
• All pre-employment checks should be fully recorded.

• The practice should review how blank prescriptions were received and distributed around the practice.

• Ensure the checks for the emergency oxygen and the defibrillator were recorded.

• Arrangements for infection control should ensure areas identified for action were followed through.

• The practice should review the arrangements for checking results and introduce a formalised processed which ensured they were reviewed within an agreed timeframe.

We undertook this focused inspection on 17 October 2016 to follow up the requirement to assess if the practice had implemented the changes needed to ensure patients who used the service were safe.

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

• The practice had reviewed and rewritten their medicine management protocols, processes for prescription security and checking emergency equipment; these had been fully implemented by the practice.

• The practice had ensured Disclosure and Barring Service checks were completed for personnel employed to carry on the regulated activities, and that all pre-employment checks were recorded.
• The practice had undertaken checks through the Disclosure and Barring Service for personnel employed to carry on the regulated activities and ensured that all pre-employment checks such as references were recorded.

• The practice had reviewed the arrangements for checking results and introduced a formalised process which ensured they were reviewed within an agreed timeframe.

The remaining area where the provider should make improvement following the inspection on 9 February 2016 is :

• Arrangements for infection control should ensure areas identified for action are followed through.

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 The Southville Surgery on 9 February 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

• Feedback from patients about their care was consistently and strongly positive.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, more appointments were requested after 5pm and new staff rotas were planned to accommodate later appointments.

• 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.
• Patients said they found it easy to make an appointment with a GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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 provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider must make improvement are:

• The medicine management policy was not fully implemented which impacted on the safe management of medicines.

The areas where the provider should make improvement are:

• The practice should ensure they undertake checks through the Disclosure and Barring Service for personnel employed to carry on the regulated activities.
• All pre-employment checks should be fully recorded.

• The practice should review how blank prescriptions were received and distributed around the practice.

• Ensure the checks for the emergency oxygen and the defibrillator are recorded.

• Arrangements for infection control should ensure areas identified for action are followed through.

• The practice review the arrangements for checking results and introduce a formalised processed which ensured they were reviewed within an agreed timeframe.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We visited the surgery. We reviewed records and systems and looked at the environment and how this impacted on the service delivery. We spoke with thirteen patients and sought feedback from a care home with nursing where the people who lived there were registered with the practice. We spoke with the practice manager, two GPs, a practice nurse, a health care assistant, a member of the reception staff and administration staff.

Patients were satisfied with the care and treatment they received from their GP. Comments from patients included “I never feel rushed, the GP will listen and they take me seriously, I feel as though I am in control” and “the service I receive has been exemplary”.

However, six of the eleven patients told us that it was not always easy to book an appointment in advance for example for a follow up or a non-urgent medical appointment. When we discussed this with one of the partners and the practice manager they were aware of this concern and provided evidence they were taking steps to improve this.

There were effective recruitment and selection processes in place to ensure suitable staff were employed at the practice.

Patients who used the service were protected from the risk of abuse, because systems had been put in place to ensure staff were trained and guidance was available.

The provider had systems in place to monitor the effectiveness and quality of the services being provided and had received positive feedback from patients.