At our previous inspection of Buxton Minor Injuries Unit (MIU) in February 2013 we found that there were inappropriate arrangements in place for the safe administration and use of medicines. We also found that the provider did not have suitable arrangements in place to ensure that staff received appropriate training, supervision and appraisal.

During this visit we did not speak with patients as their feedback did not relate to the standards we reviewed. We did speak with five members of staff and they told us that they felt supported in their roles and that they were always able to speak with someone if they had any concerns.

Staff had received an appraisal and some had received supervision. However we found that the arrangements in place to ensure that all staff received regular supervision were inadequate. We also found that staff had not received appropriate training and that the arrangements in place to ensure that temporary staff received an induction were inadequate. This meant that staff were not always being supported to deliver care and treatment safely and to an appropriate standard.

We found a number of improvements in the arrangements in place for the management of medicines. Protocols for the administration of medicines had been reviewed and updated and a schedule was in place for future monitoring. We also found that appropriate checks on medicines were taking place, including the monitoring of refrigerator temperatures and Controlled Drugs.

We visited the minor injuries unit (MIU) which is located at Buxton Hospital. The Trust delivered the regulated activities 'Treatment of disease, disorder or injury' and 'Diagnostic and screening procedures' within the MIU. The service had 651 patient attendances in January 2013. The MIU was made up of two consulting rooms and three curtained examination areas. We spoke with three patients, one relative and five members of staff across a range of roles.

Patients told us about the treatment they received at Buxton MIU. All patients told us they were satisfied with the care, treatment and service they received. We found that people were assessed and were provided with appropriate and safe treatment. However, there were insufficient arrangements in place for the safe administration and use of medicines on the unit.

Staff we spoke with told us that they enjoyed their work. We found that staff worked well with the providers of other services locally and were able to signpost or make arrangements for patients with other services as needed.

We found that the Trust did not have suitable arrangements in place to ensure that staff received appropriate training, supervision and appraisal. Staff we spoke with told us that they did not have formal supervision and that they found it difficult to find time to complete their e-learning training.