Letter from the Chief Inspector of General Practice

We carried an announced focused inspection at The Denmead Practice on 25 May 2016.

We reviewed the management of medicines, within the key question safe. We found the practice to be good in providing safe services. Overall, the practice is rated as good.

The practice was previously inspected on 9 July 2015. The inspection was a comprehensive inspection under the Health and Social Care Act 2008. At that inspection, the practice was rated good overall. However, within the key question safe, management of medicines was identified as requires improvement, as the practice was not meeting the legislation at that time.

Previously we found that there were insufficient systems in place to ensure out of date medicines were identified and disposed of, there were not the appropriate records kept of Controlled Drugs as well as the way prescription pads were kept in GP emergency bags.

The practice supplied an action plan and a range of documents which demonstrated they are now meeting the requirements of Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment.

Our Key findings on the areas we inspected on 25 May 2016

• Medicines were now managed correctly in the practice and staff had received training to improve their knowledge of managing medicines safely.

• Evidence included new policies and procedures which had been introduced. Auditing had become more stringent and completed more frequently and the practice had made the decision to not hold any controlled drugs on site.

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 Denmead Practice on 9 July 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing responsive, caring, effective and well-led services for older people, people with long term conditions, families, children and young people, working age people, people whose circumstances may make them vulnerable and people experiencing poor mental health. It required improvement for providing safe services.

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of those relating to medicines management.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles but further training needs and clinical supervision had not been identified or provided for all staff.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that 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.
• 97% of respondents to a national patient survey, published in January 2015, said their overall experience of the practice was good.
• Quality and outcome framework data for this practice in 2013/14 showed it had met 98.7% of the outcomes. This was higher than the national average of 94.2% for GP practices.

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

Importantly the provider must:

• Ensure out of date medicines are identified and disposed of and appropriate records are kept for Controlled Drugs as well as the prescription pads kept in GP emergency bags.

In addition the provider should:

• Ensure all fire safety checks are carried out.
• Obtain evidence that cleaning audits have been carried out by the external cleaning company and record visual checks carried out by the infection control lead.
• Ensure all staff receives fire safety training.
• Ensure all clinical staff receive supervision and access to relevant continuing professional development relevant to their roles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice