Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Peeler House Surgery on 19 January 2017. The overall rating for the practice was good. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for Peeler House Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 9 March 2018 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 19 January 2017. This report covers our findings in relation to those requirements.

Overall the practice is rated as good.

Our key findings were as follows:

Recruitment procedures were in place and all necessary pre-employment checks had been carried out for newly recruited 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 Peeler House Surgery on 19 January 2017. 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 generally assessed and well managed, with the exception of those relating to employment checks undertaken and the management of medicines.
• 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 found it easy to make an appointment with a named GP and 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.
• There was a clear leadership structure and staff felt supported by management. The practice proactively 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.
• Some systems and processes were not in place to keep patients safe. For example appropriate recruitment checks on three staff had not been undertaken prior to their employment.
• Systems and processes for the management of high risk medicines required improvement.
• Appropriate safeguarding training was not up to date for all staff.

The areas where the provider must make improvement are:

• Ensure recruitment arrangements include all necessary employment checks for all staff.

The areas where the provider should make improvement are:

• Embed systems and processes for the management of high risk medicines.
• Carry out clinical re-audits to ensure improvements in patient outcomes have been achieved.
• Commence regular meetings with the palliative care team to discuss care plans.
• Ensure cold chain policy reflects current practice and guidance.
• Implement a system to ensure new starters joining the service undertake a formal induction to ensure staff carry out their duties effectively and safely.Ensure systems are in place to ensure safety alerts are routinely followed up and documented to ensure safety alerts had been completed.

• Ensure all staff receive appropriate safeguarding training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice