Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the practice on 4 May 2016. A breach of legal requirements was found. After the comprehensive inspection the practice wrote to us to say what they would do to meet the legal requirements in relation to the breach of Regulations 17 and 19.

We undertook a focussed inspection on 14 December 2016 to check that they had followed their action plan and to confirm they now met their legal requirements. This report only covers our findings in relation to those requirements. You can read the last comprehensive inspection report from May 2016 by selecting the ‘all reports’ link for ‘Long Clawson Medical Practice on our website at www.cqc.co.uk

Overall the practice is rated as Good The overall rating for all the population groups are rated as good.

• We found that a new significant event system had been put in place. The policy and reporting form had been updated. Recording and investigations were detailed and actions were identified and implemented. Meeting minutes represented the discussion that took place.

• The practice had implemented an effective system for dealing with patient safety alerts.

• The Safeguarding register had been reviewed and updated.

• Risks to patients were now assessed and well managed. For example, Legionella, COSHH, medicine collection sites, hearing loop, blank prescription stationery.

• Monitoring of staff training and appraisals now took place.

• Recruitment arrangements for staff were now in line with national guidance.

• The practice now had an effective governance system in place.

• Appropriate policies and guidance are in place to enable staff to carry out their roles in a safe and effective manner which are reflective of the requirements of the practice.

The provider should:

• Review significant events to ensure any statutory notifications to CQC have been completed.

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 Long Clawson Medical Practice on 4 May 2016. Overall the practice is rated as requires improvement.

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

• The practice had a system in place for reporting and recording significant events. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However the annual review did not include dispensary significant events.
• Most risks to patients were assessed and well managed, with the exception of those relating to legionella, COSHH and medicine collection sites.
• Data from the Quality and Outcomes Framework (QOF) showed the practice had an overall rating of 97.2% compared with a national average of 94.7%. Exception reporting was 1.5% which was higher than the CCG and national average.
• Clinical audits were driving improvements to patient outcomes.
• 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.

• 100% of patients who responded to the January 2016 GP patient survey would recommend the practice to someone new to the area. 99% of patients described their overall experience of the surgery as good.

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Patients said urgent appointments were available on the same day.
• Information about services and how to complain was available and easy to understand.
• The practice had a number of policies and procedures to govern activity, but some were overdue a review.
• The practice proactively sought feedback from staff and patients, which it acted on.

The areas where the provider must make improvements are:

• Ensure there are formal governance arrangements in place including systems for assessing and monitoring risks and the quality of the service provision. For example, legionella, COSHH, medicine collection sites,

• Implement a robust policy for legionella

• Ensure recruitment arrangements include all necessary employment checks for all staff and are in line with Section 3 of the Health and Social Care Act 2008.
• Ensure blank prescriptions pads and printer stationary are handled in accordance with national guidance.

In addition the provider should:

• Ensure all significant events including those from the dispensary are recorded and discussed at practice clinical meetings.

• Ensure the safeguarding register is reviewed and updated.

• Improve and embed the practice system for the management, monitoring and improving outcomes for people

• Have a system in place to ensure all staff receive appraisals. For example, dispensary manager, reception and administration staff

• Ensure staff are aware how to use the hearing loop for patients who had difficulty in hearing and that it is fit for use.

• Ensure staff have appropriate policies and guidance to carry out their roles in a safe and effective manner which are reflective of the requirements of the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice