Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Morthen Road Group Practice on 16 May 2016. The overall rating for the practice was good but with requires improvement for safety. The full comprehensive report for the 16 May 2016 inspection can be found by selecting the ‘all reports’ link for Morthen Road Group Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 19 April 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 16 May 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.

Improvements to meet regulations had been made since our last inspection on 16 May 2016 2016. Our key findings were as follows:

• The Department of Health guidance February 2015 relating to blinds and blind cords had been implemented to minimise the risk of serious injury due to entanglement.
• Records of stock checks of medicines to ensure they were fit for use as recommended in current guidance had been implemented.
• Systems to handle blank prescription forms had been improved in accordance with national guidance.
• The facilities for handwashing had been improved to minimise the risk of cross infection.
• An infection prevention and control (IPC) risk assessment and audits had been completed and action plans had been developed.

Additionally the practice had also made the following improvements:

• Records of controlled drugs had improved and were in line with the relevant legislation.
• Medicines standard operating procedures had been signed by relevant staff.
• Distribution of medical alerts had been improved to ensure dispensary staff were kept up to date.
• The decontamination and hand hygiene procedure had been reviewed and updated and were now practice specific.
• The roles of dispensing staff and work streams in the dispensary had been reviewed and improved.
• The business continuity plan was accessible for staff.
• Medical gas warning signs had been provided on the door to the room used for storage of liquid nitrogen at Ravensfield Surgery.
• The practice had also completed patient surveys in response to concerns raised by the inspector just prior to this inspection about telephone access to the practice. The survey was mainly positive but they were going to use this information to review this area.

The practice should make improvements in the following areas:

• Review and improve effectiveness of management monitoring procedures in the dispensary and for checks of emergency medicines to ensure the practice policies and procedures are consistently and effectively implemented.
• Update and share the standard operating procedure to govern stock check activity with dispensary staff.

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 Morthern Road Group Practice on 18 May 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed with the exception of infection prevention and control (IPC) and medicines management.
• 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.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they were able to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. Some patients expressed difficulty accessing the practice by telephone.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

• There was a strong focus on continuous learning and improvement at a clinical level.

The areas where the provider must make improvements are:

• Systems to assess the risk of, and prevent and control the spread of infections must be improved.

• Embed frequent documented checks and maintain records relating to medicines management to ensure the quality and safety of services.

• Ensure medicines requiring refrigeration are stored safely, and records of fridge temperatures are maintained in accordance with national guidance.

• Implement the Department of Health guidance February 2015 relating to blinds and blind cords to minimise the risk of serious injury due to entanglement.

The areas where the provider should make improvements are:

• Maintain records of controlled drugs in accordance with the relevant legislation

• Review medicines standard operating procedures to ensure they are fit for purpose and signed by relevant staff.

• Review distribution of medical alerts so dispensary staff are kept up to date.

• Review the infection control procedure and update to reflect the practice specific activities.

• Consider the provision of children’s pads for the defibrillator.

• Review the roles of dispensing staff and work streams in the dispensary.

• Review the storage of the business continuity plan and accessibility for staff.

• Provide medical gas warning signs on the door to the room used for storage of liquid nitrogen at Ravensfield Surgery.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice