We carried out an announced comprehensive inspection at Central Surgery on 1 November 2016. The full comprehensive report can be found by selecting the ‘all reports’ link for Central Surgery on our website at www.cqc.org.uk.

At our previous inspection on 1 November 2016 we rated the practice as ‘good’ overall but as ‘requires improvement’ for safety as we identified breaches of Regulations 12 (Safe care and treatment) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This inspection was a desk-based review carried out on 3 March 2017 to confirm that the provider had carried out their plan to meet the legal requirements in relation to the breaches. This report covers our findings in relation to that and additional improvements made since our last inspection. The findings of this inspection were that the provider had taken action to meet the requirements of the last inspection and the service is now rated as good for providing safe services. Our key findings were as follows:

• The practice had addressed the issues identified during the previous inspection.

• The systems in place for monitoring medicines in fridges had been improved to include regular audits for checking and recording the temperature of the fridges. Policies and procedures had been reviewed with staff to ensure they were up to date in safe practices in maintaining safe temperatures and controlled storage of medications.

We also found that the provider had made a number of improvements where we had identified these. These included;

• The practice had reviewed the use of cleaning schedules in clinical areas which included a record and monitoring of the cleaning of medical equipment.

• The practice had reviewed the policies and procedures available for staff to ensure they were specific to the practice.

The practice had reviewed the policies and procedures available for staff to ensure they were specific to the practice.

Letter from the Chief Inspector of General Practice

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 Central Surgery, St Helens on 1 November 2016. Overall the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events. Safety alerts were received and acted upon.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.

• Infection control procedures were in place.

• Improvements were needed to ensure the safe storage of temperature sensitive medicines and to ensure medicine storage fridges were adequately serviced and maintained.

• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they could make appointments easily and urgent appointments were available the same day for all children and those patients who needed them.
• 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 improve are:

• The provider must ensure correct procedures are followed if fridge temperatures fall outside of the required range for safe storage of temperature sensitive medicines.

• The provider must ensure equipment, in particular the medicines storage fridges are serviced, calibrated and maintained to ensure they remain effective.

The areas where the provider should make improvement are:

• Review the use of cleaning schedules to include displaying them in all clinical areas and to include cleaning of medical equipment.

• Review policies and procedures to ensure they are localised and specific to the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice