Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Dr HP Borse & Partner on 17 October 2016. The overall rating for the practice was good with requires improvement in providing safe and well-led services. The full comprehensive report on the 17 October 2016 inspection can be found by selecting the ‘all reports’ link for Dr HP Borse & Partner on our website at www.cqc.org.uk.

Following the comprehensive inspection on 17 October 2016, we carried out an announced focused inspection on 27 June 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 comprehensive inspection on 17 October 2016. We continued to rate the practice as good overall with requires improvement in providing well-led services.

We carried out a further announced focused inspection on 3 January 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified at our previous inspection on 27 June 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At this inspection we found that the practice had addressed the concerns raised and is now rated as good for providing well-led services.

Our key findings were as follows:

• The practice had established systems and processes to ensure good governance in accordance with the fundamental standards of care. The practice had reviewed and improved their systems for the monitoring and management of emergency medicines held at the practice and in GP bags to ensure they were effective.

• The practice had carried out a regular analysis of significant events to identify any patterns and trends but did not document the learning.

• The practice had developed a documented prescription security protocol and there was now an effective system in place for tracking blank prescriptions throughout the practice and for ensuring the improved security of these.

• Arrangements had been made to secure the safety of fridge power points to mitigate the risk of them being accidently switched off.

However, there were also areas of practice where the provider needs to make improvements.

In addition the provider should:

• Document the learning from each significant event and include the designated person for actioning the event, date for completion and sign off date.

• Review the process for gaining GP oversight of all non-collected prescriptions before they are destroyed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Dr HP Borse & Partner on 17 October 2016. The overall rating for the practice was good with requires improvement in providing safe and well-led services. The full comprehensive report on the 17 October 2016 inspection can be found by selecting the ‘all reports’ link for Dr HP Borse & Partner on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 27 June 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 at our previous inspection on 17 October 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

• Improvements had been made in the reporting, recording and sharing of significant events to maximise learning.

• A system had been implemented to receive and act on alerts about medicines that may affect patients’ safety.

• Recruitment checks had been improved and met legislative requirements.

• All staff had been made aware of the safeguarding lead and the contact details for external safeguarding teams were accessible in most areas.

• An injectable analgesic medicine for pain relief had been obtained in the event of an emergency. However, the provider did not have an effective system in place for the monitoring and the management of emergency medicines.

• A system had been implemented for the management and security of prescription pads but this was not always effective.

• A system had been implemented for the monitoring of uncollected prescriptions.

• Fridge temperatures where vaccines were stored were checked and recorded on a daily basis. Improvements had been made to securing the safety of the power point of fridges but did not mitigate the risk of one fridge being accidently turned off.

• Some improvements had been made to the governance arrangements. However, not all arrangements for assessing and monitoring risks were effective or embedded into practice.

We also saw the following best practice recommendations we previously made in relation to providing a responsive service had been actioned:

• The complaints procedure had been made readily accessible to patients and included the escalation process should they not be happy with the outcome or the management of their complaint.

• A log of verbal complaints was maintained so that discussions with patients were recorded and analysed for trends.

However, there were also areas of practice where the provider needs to make improvements.

The provide must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. In particular, ensure systems for the monitoring and management of emergency medicines are effective.

The provider should:

• Carry out a regular analysis of significant events to identify any patterns and trends and maximise learning.

• Improve systems for the monitoring of emergency medicines held in GP bags to ensure they are in date.

• Ensure the system for tracking prescriptions through the practice is effective and prescription forms are kept secure.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Dr HP Borse & Partner on 17 October 2016. The overall rating for the practice was good with requires improvement in providing safe and well-led services. The full comprehensive report on the 17 October 2016 inspection can be found by selecting the ‘all reports’ link for Dr HP Borse & Partner on our website at www.cqc.org.uk.

Following the comprehensive inspection on 17 October 2016, we carried out an announced focused inspection on 27 June 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 comprehensive inspection on 17 October 2016. We continued to rate the practice as good overall with requires improvement in providing well-led services.

We carried out a further announced focused inspection on 3 January 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified at our previous inspection on 27 June 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At this inspection we found that the practice had addressed the concerns raised and is now rated as good for providing well-led services.

Our key findings were as follows:

• The practice had established systems and processes to ensure good governance in accordance with the fundamental standards of care. The practice had reviewed and improved their systems for the monitoring and management of emergency medicines held at the practice and in GP bags to ensure they were effective.

• The practice had carried out a regular analysis of significant events to identify any patterns and trends but did not document the learning.

• The practice had developed a documented prescription security protocol and there was now an effective system in place for tracking blank prescriptions throughout the practice and for ensuring the improved security of these.

• Arrangements had been made to secure the safety of fridge power points to mitigate the risk of them being accidently switched off.

However, there were also areas of practice where the provider needs to make improvements.

In addition the provider should:

• Document the learning from each significant event and include the designated person for actioning the event, date for completion and sign off date.

• Review the process for gaining GP oversight of all non-collected prescriptions before they are destroyed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice