Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 20 May 2015. A breach of legal requirements was found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to ensuring robust processes were in place to assess the risk of and prevent, detect and control the spread of infection, including those that are health care acquired. The flooring in a clinical room was not appropriate in order to effectively control the spread of infection.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for on our website at www.cqc.org.uk

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We visited Waterbeach Surgery on the 20 May 2015 and carried out a comprehensive inspection.

The overall rating for this practice is good. We found that the practice provided an effective, caring, responsive and well led service. Improvements were needed to ensure patients were kept safe.

We examined patient care across the following population groups: older people; those with long term medical conditions; families, babies, children and young people; working age people and those recently retired; people in vulnerable circumstances who may have poor access to primary care; and people experiencing poor mental health, including those with dementia. We found that care was tailored appropriately to the individual circumstances and needs of the patients in these groups.

Our key findings were as follows:

• Patients told us they were treated with dignity, care and respect. They were involved in decisions about their care and treatment and were highly complementary with the care that they received from the practice.
• The practice addressed patients’ needs and worked in partnership with other health and social care services to deliver care tailored to their individual needs.
• Patients were satisfied with the appointment system and many of the patients reported they were able to see a GP on the same day. They commented positively on the availability of telephone consultations, early morning and early evening appointments.
• The needs of the practice population were understood and services were offered to meet these. Feedback from care home representatives was very positive, particularly in relation to support for patients with mental health needs.
• There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on.
• There was scope to improve arrangements in relation to the safe management of medicines by ensuring the dispensary is only accessed by authorised staff and regular auditing of controlled drugs.

However, there were also areas of practice where the provider needs to make improvements. The provider must:

• Ensure that robust processes are in place to assess the risk of and prevent, detect and control the spread of infection, including those that are health care acquired. The flooring in a clinical room was not appropriate in order to effectively control the spread of infection.

In addition the provider should:

• Improve the security of the dispensary to reduce the risk of unauthorised access. This includes unauthorised access to prescription pads.
• Ensure regular audits of controlled drugs are undertaken.
• Ensure there is a robust process for checking that actions for improvement identified through significant events and complaints are completed. Near miss incidents in the dispensary should also be reported to ensure learning can be undertaken and action undertaken to minimise the risk of reoccurrence.
• Ensure that the arrangements and agreements detailed in the business continuity plan are in place.
• Ensure all staff receive an annual appraisal.
• Undertake a formal legionella risk assessment.
• Ensure all staff receive fire training every year as detailed in the fire precautions policy for the practice.
• Ensure regular inspections of the building are undertaken, as planned.

We saw one area of outstanding practice:

• The practice used pictorial guidance for patients to remember when to take their medicines. Different times of the day were depicted and the corresponding number of tablets drawn to represent the number of tablets the patient needed to take at those times. Patients with visual impairment who needed inhalers were prescribed differently shaped inhalers to enable them to tell the difference between their medicines.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice