Letter from the Chief Inspector of General Practice

This is a focused desk top review of evidence supplied by Unsworth Group Practice for one area within the key question safe.

After reviewing evidence supplied to support this inspection process we found the practice to be good in providing safe services. Overall, the practice is rated as good.

The practice was previously inspected on 17 November 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, recruitment was identified as requires improvement, as the practice was not meeting the legislation at that time. The area where the practice was told they must make improvement was as follows :

Regulation 19 (1)(3)(a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed :

• Recruitment checks were carried out and the staff files we reviewed showed that appropriate recruitment checks had been undertaken prior to employment. For example, proof of identification, qualifications, registration with the appropriate professional body where appropriate. However no evidence was available to demonstrate some of the nurses and phlebotomy staff had received Disclosure and Barring Service (DBS) checks. Not all of the staff trained to be chaperones had received a DBS check. There was no evidence of a risk assessment being conducted in relation to the need to (or not to) conduct DBS checks on the remaining practice staff. Whilst we acknowledge the provider had initiated the process to conduct DBS checks on some staff the provider must assess the different responsibilities and activities of all staff to determine if they are eligible for a DBS check. Where the decision has been made not to carry out a DBS check on staff, the practice should be able to give a clear rationale as to why.

The practice has submitted to the CQC, a range of documents which demonstrates they are now meeting the requirements of Regulation 19 (1)(3)(a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed.

In addition there were areas where the practice were told they should make improvements. These were as follows :

• The provider should take action to review their arrangements for assessing the risk from legionella.

• Clinical staff had received training in relation to consent and mental capacity. The provider should extend this training (at the appropriate level) to other members of the practice team to maximise the support provided to patients in relation to consent to care and treatment.

The practice has submitted to the CQC, a range of documents which demonstrates they have made these suggested improvements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This is a focused desk top review of evidence supplied by Unsworth Group Practice for one area within the key question safe.

After reviewing evidence supplied to support this inspection process we found the practice to be good in providing safe services. Overall, the practice is rated as good.

The practice was previously inspected on 17 November 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, recruitment was identified as requires improvement, as the practice was not meeting the legislation at that time. The area where the practice was told they must make improvement was as follows :

Regulation 19 (1)(3)(a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed :

• Recruitment checks were carried out and the staff files we reviewed showed that appropriate recruitment checks had been undertaken prior to employment. For example, proof of identification, qualifications, registration with the appropriate professional body where appropriate. However no evidence was available to demonstrate some of the nurses and phlebotomy staff had received Disclosure and Barring Service (DBS) checks. Not all of the staff trained to be chaperones had received a DBS check. There was no evidence of a risk assessment being conducted in relation to the need to (or not to) conduct DBS checks on the remaining practice staff. Whilst we acknowledge the provider had initiated the process to conduct DBS checks on some staff the provider must assess the different responsibilities and activities of all staff to determine if they are eligible for a DBS check. Where the decision has been made not to carry out a DBS check on staff, the practice should be able to give a clear rationale as to why.

The practice has submitted to the CQC, a range of documents which demonstrates they are now meeting the requirements of Regulation 19 (1)(3)(a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed.

In addition there were areas where the practice were told they should make improvements. These were as follows :

• The provider should take action to review their arrangements for assessing the risk from legionella.

• Clinical staff had received training in relation to consent and mental capacity. The provider should extend this training (at the appropriate level) to other members of the practice team to maximise the support provided to patients in relation to consent to care and treatment.

The practice has submitted to the CQC, a range of documents which demonstrates they have made these suggested improvements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We found the practice based within a modern building which was well maintained throughout. All consulting areas were on the ground level. The practice also had a branch surgery based in Blackrod which we did not visit on this inspection.

The practice’s reception area had adequate seating but as space was limited patients with prams were asked to leave them outside or collapse them if possible. Within the practice there was adequate room for patients with limited mobility or wheel chairs to move around freely and access consulting rooms.

The practice had electronic records in place to accurately describe the contact patients had with the service and the actions taken to provide appropriate care and treatment.

We found staff had access to contact details for both child protection and adult safeguarding teams. They were able to describe the appropriate actions they had taken with recent safeguarding concerns.

The practice had a range of policies and procedures in place for staff to access, which supported the safe running of the service.

The practice was bright clean and airy and had appropriate infection prevention and control systems in place.

The practice leaflet and website were informative and provided patents with a range of information including how to raise a concern. Patients we spoke with told us they would raise any concerns with the clinical or reception staff.

Patients told us; “You don’t wait long for appointments if you don’t mind which doctor you see. If you want a specific one you may have to wait a number of days”. “I feel the practice has improved as time has gone on I am pleased with the service I get”. “I feel safe here, I am comfortable with the doctors and trust them”. “My X works late and the practice is great as they offer evening appointments he can access. We have recently moved to this practice and it was their reputation that drew us here and up to now we have not been disappointed”.