We carried out an announced focused inspection on 4 May 2018 to follow up concerns we found at an inspection we carried out at Merton Lodge Surgery on 14 June 2017. Overall the practice is rated as good.

At our previous inspection on 14 June 2017 we found that risks to patients were not always assessed and well managed. Where risks had been identified following a fire risk assessment and action was required, no remedial action had been taken. We issued the provider with a requirement notice.

At our inspection on 4 May 2018 we found that the provider had taken the appropriate action and that all the areas identified for improvement in the fire risk assessment had 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 desk based follow up inspection on 14 June 2017 to follow up concerns we found at Merton Lodge Surgery on 18 February 2016. Overall the practice is rated as good.

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

• Risks to patients were not always assessed and well managed. We found that where risks had been identified following a fire risk assessment undertaken and action was required, no remedial action had been taken.

• The practice had revised processes in place since our last inspection to ensure the safe handling, security and tracking of blank prescription pads and forms within the practice when transferred from the main stock to prescribers.

• The practice had installed a door entry system to the entrance to the dispensary for security purposes to ensure access was restricted to ensure the safe storage and security of medicines.

The areas where the provider must make improvements are:

• Ensure that where risks to the safety of patients and others have been identified, appropriate action is taken to mitigate those risks.

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 Merton Lodge Surgery on 18 February 2016. Overall the practice is rated as good.

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

• The majority of staff we spoke with understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. However we found that some staff were reluctant to report serious events as they had a perception that it would lead to disciplinary action.
• Risks to patients were assessed. However we found that where risks had been identified and action was required, no remedial action had been taken.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• There was an ongoing program of clinical audit aimed at improving patient safety and care.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was readily available and easy to understand.
• There was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Medicines management was generally good, however there were issues with the secure storage of prescription pads and access to medicines.
• There was a clear leadership structure and staff felt supported by management.

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

Importantly the provider must ;

• The provider must follow nationally accepted guidance on the secure storage of prescriptions.

• Ensure that where identified risks to the safety of patients and others have been identified, appropriate action is taken to mitigate those risks.

In addition the provider should;

• Review the security of medicines storage.

• Review the dispensing procedure to reflect current practice and to align with the practice standard operation procedures.

• Ensure that an open culture with regard to the reporting of dispensing errors and serious events is embedded throughout the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice