Letter from the Chief Inspector of General Practice

We carried out an announced inspection of this practice on 15 September 2015 during which a breach of a legal requirement set out in the Health and Social Care Act (HSCA) 2008 was found:

• Regulation 12 HSCA 2008 (Regulated Activities) Regulations 2014: Safe care and treatment

Care and treatment was not being provided in a safe way for service users through the proper and safe management of medicines. Specifically, the arrangements for storing and recording controlled drugs needed reviewing and strengthening to comply with schedule 2 of the Misuse of Drugs (Safe Custody) regulations 1973

On the 19 April 2016 we commenced a focussed inspection to check that the provider had taken action to address this issue and that they now complied with legal requirements. This report only covers our findings in relation to this requirement. You can read the report from out last comprehensive inspection by selecting the ‘all reports’ link for Dr NA Joshi on our website at www.cqc.org.uk.

Our key findings were as follows:

• The practice had addressed the issue identified during the previous inspection and had ensured that care and treatment was provided in a safe way for service users through the proper and safe management of medicines for the purposes of carrying on the regulated activity.

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 Dr Joshi, Village Surgery on 15 September 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing caring, effective, responsive and well-led services. We found the practice required improvement for providing safe services.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses;
• Risks to patients and staff were assessed and well managed;
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and responsibilities;
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand;
• Patients said they were treated with compassion, dignity and respect and were involved in decisions about their care and treatment.
• The majority of patients who provided us with feedback did not raise any concerns over access to appointments. Results from the National GP Patient Survey showed that patient satisfaction with access to appointments, practice opening hours and appointment waiting times was broadly in line with local CCG and national averages;
• There was a clear leadership structure and staff felt well-supported by the management team. Good governance arrangements were in place;
• Staff had a clear vision for the development of the practice and were committed to providing their patients with good quality care. This was demonstrated by the steps staff were taking to develop additional services to meet the needs of their patients.

However, there was also an area where the practice must make improvements.

Importantly, the provider must:

• Ensure that the arrangements for storing and recording controlled drugs is reviewed and strengthened to comply with schedule 2 of the Misuse of Drugs (Safe Custody) Regulations 1973

In addition the provider should:

• Ensure that all staff receive comprehensive infection control training.

• Ensure that the practice has a regular schedule of meetings and that practice and multi- agency meetings are minuted more effectively

• Review the system currently in place for planning, carrying out, recording and reviewing clinical audits

• Make better use of the patient participation group and ensure that consideration is given to disseminating learning and information from speakers attending PPG meetings to the practice population on a whole

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice