Archived: The Forge Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Forge Surgery on 13 April 2016r. The overall rating for the practice was good. The practice was rated as requires improvement for providing safe services and good for providing effective, caring, responsive and well led services. The full comprehensive report on the 13 April 2016 inspection can be found by selecting the ‘all reports’ link for The Forge Surgery on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection on 14 September 2017. Overall the practice is rated as requires improvement.

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

• There was an open and transparent approach to safety and a system for reporting significant events. The recording of events, relating to the duty of candour, was limited. The practice did not always keep records of action taken (or if no action was necessary) in response to receipt of all patient safety alerts.
• The practice had some defined and embedded systems to minimise risks to patient safety. However some areas such as infection prevention control and lone working.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Some areas of governance for example, implementation of infection control measures, management of safety alerts and the duty of candour required improvement.
• 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. .

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition the provider should:

• Review the use of patients’ records so that staff can better identify vulnerable adults and children.

• Review the arrangements for lone working to ensure that appropriate help was available to staff in the event of an emergency.

• Review the reporting of significant events. The current reporting system did not include the need to consider the duty of candour.

• Review the arrangement for management of infection prevention and control to ensure they are effective.

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 Forge Surgery on 13 April 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events, however one significant event had not been recorded.
• Risks to patients were assessed and generally well-managed; there were systems and processes implemented to mitigate risks to patients.

• 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.

• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with all appointments available the same day.

• 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.

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a number of policies and procedures to govern activity, but some of these needed to be updated and accessible to all staff members.
• 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 improvements are:

• Ensure all events that are significant and adverse are recorded and shared to mitigate the risk of a reoccurrence.
• Review the staffing levels at the practice to ensure that there are enough suitably qualified and experienced staff to meet the care and treatment needs of the patients, in light of the significant continued increase in patient registrations.

In addition the provider should:

• Review access to the sharps injury policy to ensure all staff are aware of it and that local information is displayed for their attention.

• Review staff access to all policies and procedures to ensure they are available at all times.
• Update the business continuity plan so that it reflects the Clinical Commissioning Group (CCG) rather than the Primary Care Trust (PCT), which is no longer current.
• Put a process in place to document weekly clinical meetings.
• Ensure that the latest schedule from Public Health England (PHE) regarding vaccines is available at the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice