Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection of The Yoxall Practice on 5 September 2016. The overall rating for the practice was good with requires improvement for providing a safe service. The full comprehensive report on the 5 September 2016 inspection can be found by selecting the ‘all reports’ link for The Yoxall Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 6 July 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations identified at our previous inspection on 5 September 2016. This report covers our findings in relation to those requirements.

Our key findings were as follows:

• The provider had implemented an effective system to manage the safe care of patients on high risk medicines.
• Effective checking systems were in place to ensure that emergency procedures are tested and emergency equipment is maintained and fit for use.
• Clinical staff completed annual refresher courses in basic life support training and non-clinical staff were required to complete the same refresher course bi-annually.
• Actions identified as required in the infection prevention control audits had been completed or planned.
• Learning from significant events had been shared with appropriate staff, and following review, resultant action taken. There had been a significant increase in the number of events recorded.
• The provider had implemented an effective system to monitor the use of prescription pads and forms.
• The provider had risk assessed the process of taking repeat medication requests by telephone. Individual cases were reviewed where the cessation of this service may result in a detrimental impact on an individual’s care.
• Audits had been carried out to ensure nationally recognised clinical guidelines are followed.
• The practice had adopted a proactive approach in identifying patients who also act as carers. This included the appointment of a carers’ lead and liaison with the local secondary school to help identify young carers.
• Verbal complaints had been recorded to enable trends to be identified and the wider practice team were involved with reviewing complaints.

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 Yoxall Health Centre on 5 September 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. However there was not always evidence that learning had been shared and some recent events had not been recorded.
• 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.
• Some risks to patients and staff had been assessed but no fire evacuation drill had been undertaken in the preceding 12 months and the oxygen cylinders had exceeded their expiry date.
• Recruitment checks had been completed on all staff but no health assessment carried out to identify any underlying conditions.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients generally spoke of a high level of service but the feedback on the nurse was significantly below local and national averages.
• Information about services and how to complain was available and easy to understand.
• 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, patients and third party organisations, which it acted on.
• Patients said they found it easy to make an appointment. Urgent appointments were available on the day.

The areas where the practice must make improvements are:

• Implement an effective system to manage the safe care of patients on high risk medicines.
• Implement an effective checking system to ensure that emergency procedures are tested and emergency equipment is maintained and fit for use.

The areas where the practice should make improvements are:

• Ensure actions stated in the infection prevention control audits are completed or planned.
• Ensure significant events are recorded, reviewed and learning shared with appropriate staff.
• Introduce a system to monitor the use of prescription pads and forms.
• Risk assess the process of taking repeat medication requests by telephone.
• Ensure that all clinical staff complete a refresher course in basic life support training in accordance with the practice policy.
• Implement a system to ensure nationally recognised clinical guidelines are followed.
• Explore how the practice can be more proactive in identifying patients who also act as carers.
• Record verbal complaints to enable trends to be identified. Include the wider practice team when reviewing complaints.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice