Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Longton Hall Surgery on 4 July 2016. The overall rating for the practice was Good with requires improvement in providing safe services. The full comprehensive report from the 4 July 2016 inspection can be found by selecting the ‘all reports’ link for Longton Hall Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 13 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 previous inspection on 4 July 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:

• The provider had improved their system and processes for ensuring they had received all alerts issued by external agencies about medicines that may affect patients’ safety. However, they were not consistently running searches to identify patients that may be at risk associated with the alerts.

• The provider had ensured recruitment checks for most staff met legislative requirements.

• The provider had improved the system for ensuring that the monitoring of patients who took long term medicines on a shared care basis had taken place before medicines were prescribed.

• The provider had reviewed and updated their risk register of vulnerable patients and these patients were clearly identified to staff on the practice computer system.

• A programme of continuous clinical and internal audit to monitor quality and to make improvements had been implemented.

We also saw the following best practice recommendations we previously made in relation to providing effective and caring services had been actioned:

• The provider had improved the identification of patients on their register who were carers and were looking to embark on a carers’ scheme.

• The provider had ensured that all staff had timely access to training including safeguarding adults and infection control.

However, there was still an area of practice where the provider could make improvements.

The provider should:

• Ensure searches are carried out to identify any patients that may be at risk associated with all alerts received from external agencies that may affect patient safety, for example from the Medicines and Healthcare products Regulatory Agency (MHRA), and actioned.

• Include parents and siblings of children recorded on the safeguarding register.

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 Longton Hall Surgery on 4 July 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses.

• Risks to patients were assessed but not always effectively managed.

• Patients’ needs were assessed and care was planned and delivered in line with current evidence based guidance.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Information about how to complain was available and readily accessible. The practice responded quickly to issues raised.

• The practice had good facilities and was equipped to treat patients and meet their needs.

• There was a clear staffing structure. Staff were aware of their own roles and responsibilities. The team worked efficiently and felt supported in their work.

• The practice proactively sought feedback from staff and patients, which it acted on.

• The practice had an active patient participation group, had implemented suggestions for improvements, and had made changes to the way it delivered services as a consequence of feedback.

• Access had improved following a review of the appointment system.

• Staff had developed positive working relationships and held regular meetings with healthcare professionals involved in the care of the patients.

The areas where the provider must make improvement are:

• Improve the system to act on alerts about medicines that may affect patients’ safety.

• Ensure recruitment checks for staff meet legislative requirements.

• Implement a programme of continuous clinical and internal audit to monitor quality and to make improvements.

The provider should:

• Improve the system for ensuring that monitoring of patients who take long term medicines on a shared care basis, has taken place before the medicines are prescribed.

• Improve the identification of patients who may be carers.

• Ensure that all persons employed by the service have timely access to training including safeguarding adults and infection control.

• Ensure the registers held of vulnerable children and adults are current and vulnerable patients clearly identified to staff on the practice computer system.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice