Letter from the Chief Inspector of General Practice

We had previously carried out an announced comprehensive inspection at The Old School Surgery on 29 September 2016 and found breaches of regulation and rated the practice as ‘Requires improvement’ in the safe key question. However the practice was rated as good overall. The full comprehensive report on the 29 September inspection can be found by selecting the ‘all reports’ link for The Old School Surgery on our website at www.cqc.org.uk.

Specifically we found that;

• The Greencroft annex branch surgery did not have an effective fire risk assessment in place.

• Self-employed and casual workers had not been subject to the appropriate scrutiny to ensure their suitability for working at the practice.

• The arrangements in place for responding to a medical emergency at the branch surgery required review.

• Consultation room doors were not always closed to maintain privacy and confidentiality.

• The clinical waste bin was not adequately secured.

This inspection was an announced focused inspection carried out on 12 January 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 29 September 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

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Overall the practice is now rated as ‘Good’ in the safe key question and ‘Good’ overall.

Our key findings were as follows:

• A fire risk assessment for the Greentcroft annex had been completed by an external company and improvements in line with the report’s recommendations made.

• The practice had put measures in place to ensure the appropriate scrutiny of part time staff and self-employed workers.

• The procedures for dealing with a medical emergency had been reviewed.

• All staff had been reminded of the need to ensure privacy and confidentiality when treating patients.

• The clinical waste bin at the Greencroft annex branch surgery was suitably secured.

• Staff working at the Greencroft annex branch surgery had been issued with personal alarms to give them re-assurance and support when working in this location.

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 The Old School Surgery on 29 September 2016. Overall the practice is rated as good.

• 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. However the arrangements for responding to a medical emergency at the Greencroft Annex branch surgery needed reviewing.

• There had been no assessments completed for the Greencroft Annex branch surgery in respect of fire risk . In addition we saw that the external clinical waste bin was not adequately secured to prevent unauthorised access.

• 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. However we saw that one member of staff was treating a patient with the consultation room open and the conversation clearly audible.
• Staff had been recruited in a manner that helped to ensure patient safety however self-employed and casual staff had not been subject to similar scrutiny.
• 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.
• All patients had a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had accessible facilities and was 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.

The areas where the provider must make improvement are:

• Ensure that the Greencroft Annex branch surgery is subject to effective fire risk assessment and fire drills.

• Obtain assurance that self-employed and casual workers are suitable people to work in a heathcare environment.

In addition the provider should:

• Review the arrangements in place for responding to a medical emergency at the branch surgery.

• Re-inforce with all the staff the need for consultation room doors to be closed to maintain privacy and confidentiality.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our visit we spoke with six patients and seven staff. The six patients we spoke with expressed a high level of satisfaction with the service they received. One patient told us: "This is a slick well run surgery. If something goes wrong in reception you see the practice managers come down and sort it out." Another patient commented: "The doctor read my notes before I came into the room and took an interest and treated me well". All of the patients we spoke with told us they felt safe when they visited the practice. They told us they had confidence in the staff. Two patients commented they always requested to see the female doctor and felt they could talk freely. The six patients we interviewed told us doctors listened to them and respected their views and decisions about their own health. One patient said: "Quite impressive, my doctor really listens to me." Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.