Letter from the Chief Inspector of General Practice

When we visited Morland House Surgery in February 2015 we found the practice had breached regulations, that were in force at that time, relating to the safe delivery of services.

We found the practice required improvement for the provision of safe services because improvements were needed in the way medicines were managed and some relevant staff checks had not been undertaken. Overall the practice was rated as good.

Morland House Surgery sent us an action plan that set out the changes they would make to improve the management of medicines and complete relevant staff checks. Subsequently they supplied information to confirm they had completed the actions.

This focused inspection was undertaken to check the practice was meeting the regulation previously breached. For this reason we have only rated the location for the key question to which this related. This report should be read in conjunction with the full inspection report of 25 February 2015.

We found the practice had made improvements since our last inspection. The information we received enabled us to find the practice was meeting the regulations that it had previously breached.

Specifically Morland House Surgery was:

• Operating a consistent system of ensuring tests required by patients taking high risk medicines were completed and dosage of prescribing undertaken based on the results.

• Ensuring all staff that undertook chaperone duties had completed a disclosure and barring service (DBS) check. (These checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

• Operating a consistent system to maintain security of blank prescriptions.

• Keeping emergency medicines under review and had risk assessed the medicines required.

• Carrying out robust monitoring of cleaning standards

• Monitoring clinical audit via weekly clinical review meetings.

We have updated the rating for the safe domain for this practice to reflect the changes they made. The practice is now rated good for the provision of safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We inspected Morland House Surgery on 25 February 2015. This was a comprehensive inspection. The practice had been inspected in July 2014 when we were testing our new approach to inspection. We returned to check that the practice had acted to address issues which breached regulations relating to management of medicines reported at the previous inspection and to enable us to apply a judgement of ratings for the practice.

The practice is rated as good overall. Patients received care and treatment from a team of staff who place patient satisfaction at the core of their work. Patients we spoke with and other sources of patient feedback confirmed that the GPs and staff were caring and responded promptly to patient needs. A range of visiting care professionals attended the practice to provide convenient access to services. The practice had taken action on the issues relating to medicines management reported previously. Significant improvement had been achieved. However, the practice must improve on other aspects of how medicines are managed.

Our key findings were as follows:

• The practice was clean and tidy and there were systems in place to reduce the risk and spread of infection.
• Patients found access to the service met their needs. Sufficient appointments were available to meet demand and there was a flexible approach to provision of appointments that were convenient for patients.
• Staff treated patients in a friendly and professional manner. This was reflected in the results of both local and national patient surveys.
• GPs treated patients in accordance with national and local guidelines. Staff are trained and knowledgeable.
• The practice worked with other services to ensure patients with complex needs are cared for appropriately. Health visitors told us there are good working arrangements with the GPs.

We saw several areas of outstanding practice including:

• The practice provides a wide range of additional services on site to give local access to patients and reduce the need to visit hospital or other care providers.

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

Importantly, the provider must:

• Introduce a tracking system for blank prescriptions which records when they are issued to individual GPs.

• Ensure the system for prescribing high risk medicines is operated consistently.

In addition the provider should:

• Ensure cleaning of high level surfaces is carried out effectively in consulting rooms.

• Carry out a risk assessment to determine whether all relevant medicines are held in the emergency medicines stock.

• Increase the number of audit cycles to monitor clinical quality and systems to identify where action could be taken.
• Consider carrying out DBS checks for reception staff who undertake chaperone duties.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

When we visited Morland House Surgery in February 2015 we found the practice had breached regulations, that were in force at that time, relating to the safe delivery of services.

We found the practice required improvement for the provision of safe services because improvements were needed in the way medicines were managed and some relevant staff checks had not been undertaken. Overall the practice was rated as good.

Morland House Surgery sent us an action plan that set out the changes they would make to improve the management of medicines and complete relevant staff checks. Subsequently they supplied information to confirm they had completed the actions.

This focused inspection was undertaken to check the practice was meeting the regulation previously breached. For this reason we have only rated the location for the key question to which this related. This report should be read in conjunction with the full inspection report of 25 February 2015.

We found the practice had made improvements since our last inspection. The information we received enabled us to find the practice was meeting the regulations that it had previously breached.

Specifically Morland House Surgery was:

• Operating a consistent system of ensuring tests required by patients taking high risk medicines were completed and dosage of prescribing undertaken based on the results.

• Ensuring all staff that undertook chaperone duties had completed a disclosure and barring service (DBS) check. (These checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

• Operating a consistent system to maintain security of blank prescriptions.

• Keeping emergency medicines under review and had risk assessed the medicines required.

• Carrying out robust monitoring of cleaning standards

• Monitoring clinical audit via weekly clinical review meetings.

We have updated the rating for the safe domain for this practice to reflect the changes they made. The practice is now rated good for the provision of safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice