Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection of Farnham Dene Medical Practice, Farnham Centre for Health, Farnham, Surrey, GU9 9QS on 28 June 2016. The inspection was undertaken to check that the practice was making improvements following an inspection on 24 September 2015 where we found breaches in regulations relating to safe delivery of services. At the inspection on 24 September 2015, the practice was rated good overall and good for providing effective, caring, responsive and well-led services. The practice was rated as requires improvement for safe.

We found the practice had made improvements since our last inspection on 24 September 2015 and was meeting the regulations that had previously been breached.

Our key findings for this review were as follows:

• The practice had reviewed and implemented changes to the recording of their cleaning schedule for equipment used.

• The practice had ensured all Patient Group Directions (PDGs) had been signed by staff authorised to administer vaccines.

We have amended the rating for this practice to reflect these changes. The practice is now rated as good for the provision of safe, effective, caring, responsive and well-led services. The overall rating for the practice remains good.

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 focused inspection of Farnham Dene Medical Practice, Farnham Centre for Health, Farnham, Surrey, GU9 9QS on 28 June 2016. The inspection was undertaken to check that the practice was making improvements following an inspection on 24 September 2015 where we found breaches in regulations relating to safe delivery of services. At the inspection on 24 September 2015, the practice was rated good overall and good for providing effective, caring, responsive and well-led services. The practice was rated as requires improvement for safe.

We found the practice had made improvements since our last inspection on 24 September 2015 and was meeting the regulations that had previously been breached.

Our key findings for this review were as follows:

• The practice had reviewed and implemented changes to the recording of their cleaning schedule for equipment used.

• The practice had ensured all Patient Group Directions (PDGs) had been signed by staff authorised to administer vaccines.

We have amended the rating for this practice to reflect these changes. The practice is now rated as good for the provision of safe, effective, caring, responsive and well-led services. The overall rating for the practice remains good.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

This was a follow up inspection to check the provider had taken the required actions to meet essential standards following our previous inspection in February 2014.

During this inspection we spoke with four staff members which included the practice manager, the practice nurse and reception staff.

People were protected from abuse through the provision of staff training, the presence of clear policies and the availability of information to staff and people who used the service.

The provider had taken steps to ensure that appropriate systems were in place to manage medicines. Records demonstrated that internal auditing to check the correct storage of medicines was carried out effectively.

Since our last inspection, the provider had taken some steps to improve their recruitment processes. However, the provider remained unable to demonstrate that all appropriate checks were made before staff began work.

We found the provider had taken steps to ensure that staff received regular appraisal. Staff we spoke with told us they felt well supported in their role. Effective arrangements were in place to ensure staff completed training appropriate to their role and to facilitate continuing learning and development.

During our inspection of Farnham Dene Medical Practice we spoke with six staff, including GPs, nurses and reception staff. We also collected ten responses to a survey questionnaire we left in the patient waiting area.

People commented that they were treated with dignity and respect and that they felt involved in their treatment. One person commented ‘I am always given information and choices regarding my care.’ A second person commented ‘The staff are always helpful and friendly.’ People commented that the care they received at the surgery was good. One person commented ‘The care I receive here is excellent.’

We found that whilst staff were aware of procedures around safeguarding children they were unsure about safeguarding vulnerable adults. Furthermore none of the staff had undertaken training regarding the protection of vulnerable adults. We found that the practice had good processes in place to manage infection control and all of the appropriate staff had undertaken training in this regard. People commented that the surgery was clean. One person commented ‘It is a comfortable clean environment.’

There were no policies or procedures in place to manage the risks regarding medicines.

The staff recruitment practices were not robust and some staff had not had the required checks undertaken prior to or since starting work at the practice. The staff that we spoke with all felt supported. One member of staff said "100%!" However there were shortfalls in the supervision and appraisal processes and some health and safety training had not been provided.

There were clear procedures in place regarding complaints management and people felt their complaints were dealt with appropriately and in a timely manner. One person commented ‘I complained once and it was responded to quickly.’