Letter from the Chief Inspector of General Practice

The practice was rated requires improvement overall. It is now rated as good overall and good for providing safe services

We carried out a focused inspection on 24 April 2017 to check that the provider had followed their action plan and to confirm that they now met legal requirements. Continued breaches of legal requirements were found during that inspection within the safe domain. After the focused inspection, the practice sent us an action plan detailing what they would do to meet the legal requirements. We conducted a further focused inspection on 11 September 2017 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

During our previous inspection on 24 April 2017 we found the following area where the practice must improve:

• Put a system in place to track the use of blank prescription stationery throughout the practice so that theft or misuse can be identified.

You can read the report from our last inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During the inspection on 11 September 2017 we found:

• Effective arrangements for the tracking of blank prescription stationery had been put in place.

.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

The practice was rated requires improvement overall. It is now rated as good overall and for providing effective and well led services. It is still rated as requires improvement for providing safe services

We carried out an announced comprehensive inspection of this practice on 16 September 2016. Breaches of legal requirements were found during that inspection within the safe, effective and well led domains. After the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the legal requirements. We conducted a focused inspection on 24 April 2017 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

During our previous inspection on 16 September 2016 we found the following areas where the practice must improve:

• Ensure recruitment arrangements include all necessary employment checks for all staff. Put arrangements in place to check the registration status of all health care professionals employed by the practice on an ongoing basis.

• Put arrangements in place to ensure that all clinical staff have up to date indemnity insurance in place in line with statutory requirements.

• Ensure all staff receive up to date training on safeguarding children and vulnerable adults relevant to their role. Implement an up to date, accurate policy for safeguarding vulnerable adults that reflects local authority safeguarding policies and procedures.

• Ensure all staff receive up to date training on areas identified as mandatory such as health and safety, fire safety, information governance, infection control and moving and handling.

• Ensure all staff receive a regular appraisal of performance in their role from an appropriately skilled and experienced person and that any training, learning and development needs are identified, planned for and supported.

• Carry out clinical audits including re-audits to ensure improvements have been achieved.

• Store prescription pads and blank prescription stationery securely at all times and track their use through the practice.

• Take action to address identified concerns with infection prevention and control practice.

Our previous report also highlighted the following areas where the practice should improve:

• Ensure that information is accessible for all patients. For example, the introduction of a hearing loop in reception for patients with hearing difficulties and the production of information in large print and braille for those with visual impairment.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During the inspection on 24 April 2017 we found:

• Appropriate recruitment arrangements had been put in place and the necessary employment checks had been undertaken for all staff. All staff were registered correctly with professional bodies and the practice put a system in place to ensure this was checked on an annual basis.
• All clinical staff had indemnity insurance in place in line with statutory requirements and there was a system in place to ensure that cover did not lapse.
• All clinical staff had undertaken training on safeguarding appropriate for their role. Training dates had been arranged to ensure all administrative and clerical completed their safeguarding training by the end of April 2017.
• The practice had implemented an up to date, accurate policy for safeguarding for vulnerable adults that reflected local authority safeguarding policies and procedures.
• The practice had invested in and implemented an online training system to ensure all staff were able to access and complete training identified as mandatory. Staff had undertaken training in key areas including health and safety, infection control and information governance. There was system in place to ensure all staff completed their training and that it was kept up to date.
• All staff had either had a recent appraisal since our last inspection or had a date booked. Arrangements had been put in place with the clinical commissioning group to ensure that nursing staff had appropriate clinical input to their appraisals and ongoing supervision.

• The practice had undertaken a second cycle audit since our last inspection. The practice now had a plan in place for each GP to undertake one clinical audit per year.

• Concerns identified at the last inspection in relation to infection prevention and control had been addressed.

• Effective arrangements for the tracking of blank prescription stationery had not been put in place.

We also found in relation to the areas where the practice should improve:

• The practice was in the process of introducing a hearing loop. The practice’s patient participation group was working with the practice on improving information provided to patients.

The areas where the provider must make improvements are:

• Put a system in place to track the use of blank prescription stationery throughout the practice so that theft or misuse can be identified.

.

.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

The practice was rated requires improvement overall. It is now rated as good overall and good for providing safe services

We carried out a focused inspection on 24 April 2017 to check that the provider had followed their action plan and to confirm that they now met legal requirements. Continued breaches of legal requirements were found during that inspection within the safe domain. After the focused inspection, the practice sent us an action plan detailing what they would do to meet the legal requirements. We conducted a further focused inspection on 11 September 2017 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

During our previous inspection on 24 April 2017 we found the following area where the practice must improve:

• Put a system in place to track the use of blank prescription stationery throughout the practice so that theft or misuse can be identified.

You can read the report from our last inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During the inspection on 11 September 2017 we found:

• Effective arrangements for the tracking of blank prescription stationery had been put in place.

.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice