Letter from the Chief Inspector of General Practice

We carried out a focused desk based inspection of Cornhill Surgery on 21 February 2017 to check that action had been taken since our previous inspection on 28 June 2016. At the inspection in June 2016, the practice was rated as good overall but rated as requires improvement for providing safe services.

We found that the practice required improvement in this area due to a breach of regulation relating to safe care and treatment. This was because:

• the practice had not undertaken a Legionella risk assessment, therefore the risk to patients and staff of infection by the Legionella bacteria had not been established.

On 21 February 2017 we reviewed the information the practice submitted to us to ensure that they had followed their action plan and to confirm that they now met legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection of Cornhill Surgery on our website at www.cqc.org.uk.

Our key findings for this inspection were as follows:

The provider had made improvements:

• They had commissioned the services of an external contractor to carry out Legionella testing, and had continued to receive ongoing regular assessments from them.

The provider had also addressed all areas which had been identified that actions should take place to improve practice which are detailed in the report.

The practice is now rated good for providing safe services.

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 Cornhill Surgery on 28 June 2016. Overall the practice is rated as good.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. The GPs had weekly meetings to discuss concerns and share learning. However it was not always clear who the lead was for particular roles such as safeguarding and infection control.

• There was a leadership structure and staff felt supported by the GPs and the practice manager. The practice proactively sought feedback from staff and patients which it acted on.

• Prescriptions were securely stored, however they were not signed for on receipt and they did not record serial numbers. The practice stated that an audit trail to govern prescriptions would be introduced following the inspection.

• The practice was aware of and complied with the requirements of the duty of candour.

• Risks to patients were generally assessed and well managed, although at the time of the inspection the practice had not carried out a legionella risk assessment, regular infection control audits and a risk assessment in relation to equipment checks.

• The fire alarm was tested every week but we did not see evidence of staff receiving fire training or that regular fire drills were carried out. Following the inspection the practice has provided evidence to confirm that staff have had now received fire training.

• Patients described staff as caring and helpful. Patients commented that they were treated with dignity and respect

• 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.

We saw two areas of outstanding practice:

• One of the GP partners paid for a weekly social group for older patients at a community centre. On average 30 people attended per week. Patients were able to bring friends from different practices if they wished.Two of the patients we spoke with during the inspection told us how beneficial this had been for patients who were socially isolated. This took place every Wednesday afternoon. The patients were given refreshments and played games such as bridge and chess. The GPs sometimes organised external speakers such as carer organisations and the citizens advice bureau to speak with the group. The practice used the opportunity to give advice around maintaining health.

• All of the practice team had received deaf awareness training and had ordered a hearing loop following this training. All patients with a hearing or visual impairment were highlighted on the system and alerts were put on so that patients were collected from the waiting area.

However, there were areas of practice where the provider should make improvements:

The provider should:

• Implement a system to ensure the safe management of prescribing stationery across the practice.

• Ensure that systems are in place so that risk assessments and equipment checks are documented.

• Ensure that all staff at the practice are aware of which members of the team are the leads for specific areas of responsibility such as infection control and safeguarding.

• Ensure that all staff are aware of the systems and processes in place for safeguarding children and vulnerable adults.

• Review fire safety and evacuation procedures to ensure patients and staff safety in the event of a fire.

• Carry out a regular infection control audit.

• Strengthen governance systems in place at the practice to ensure all risks are acted on effectively.

The provider must:

• Carry out a legionella risk assessment

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice