Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Church Farm Surgery on 22 July 2016. The overall rating for the practice was Good with requires improvement for providing safe services. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Church Farm Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 11 April 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 22 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good for the safe domain. However on the inspection of 22 July 2016, there were areas of practice where the provider needed to make improvements.

We found that the provider must:

• Ensure records relating to the recruitment and management of staff are complete and include Disclosure and Barring Service (DBS) checks for all clinical staff. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).
• Ensure systems in place are sufficient to ensure patients who were prescribed high risk medicines had the necessary monitoring to support safe prescribing. The practice must ensure the results of appropriate blood monitoring tests are recorded in the patients’ records.

In addition we found the practice should;

• Ensure patients waiting for their appointments in all areas of the practice could be clearly seen by reception staff to enable closer monitoring in case of change in condition.
• Implement an extended clinical audit programme to encompass outcomes wider than prescribing.
• Continue to ensure patients with a learning disability receive annual health checks.
• Continue to proactively identify carers.
• Undertake regular fire drills.

At this inspection, on 11 April 2017, we found evidence that;

• The practice had developed a system to ensure that records relating to the recruitment and management of staff were in place. We saw that DBS checks had been undertaken for all clinical staff and a process was in place to audit all records relating to new staff recruitment.
• The practice had ensured the results of appropriate blood monitoring tests were recorded in the patients’ records to ensure the necessary monitoring was in place for safe prescribing.

The areas where the provider should continue to make improvement are;

• Continue to risk assess and monitor patients waiting for their appointments in all areas of the practice, to ensure they can be clearly seen by staff to enable closer monitoring in case of a change in their condition.
• Implement an extended clinical audit programme to encompass outcomes wider than prescribing.
• Improve staff understanding of the computer operating system in order to consistently code patient groups and produce accurate performance data.
• Continue to ensure patients with a learning disability receive annual health checks.

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 Church Farm Surgery on 22 July 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. However not all staff had undergone DBS checks prior to their employment.

• 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.
• 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 found it easy to make an appointment with a named GP and 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 provider must ensure that records relating to the recruitment and management of staff are complete and include Disclosure and Barring Service (DBS) checks for all clinical staff. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).
• The practice must ensure systems in place are sufficient to ensure patients who were prescribed high risk medicines have the necessary monitoring to support safe prescribing. The practice must ensure the results of appropriate blood monitoring tests are recorded in the patients records.

The areas where the provider should make improvement are:

• Ensure patients waiting for their appointments in all areas of the practice can be clearly seen by reception staff to enable closer monitoring in case of change in condition.
• The practice should implement an extended clinical audit programme to encompass outcomes wider than prescribing.
• Continue to ensure patients with a learning disability receive annual health checks.
• Continue to proactively identify carers.

• Undertake regular fire drills.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice