26 October 2017
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr Andrew Whitfield (also known as Southwood medical practice) on 4 October 2016, The practice was rated requires improvement overall with an inadequate rating for providing safe services. Areas where the provider needed to make improvements included reviewing the processes for implementing infection control policies, maintaining a good overview of systems and processes to mitigate risk including prescription stationary security and processes around staff administration of vaccines. Additionally, the reviewing and monitoring systems to identify staff training and to review policies and procedures.
We conducted a further comprehensive inspection on 26 October 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified at our previous inspection on 4 October 2016. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.
Our key findings across all the areas we inspected were as follows:
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Improvements had been made to the monitoring of infection control processes. This included undertaking further infection control audits and reviewing systems to incorporate and monitor actions required.
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The practice had reviewed strategies for storing and checking of patient group directions (PGDs) and patient specific directions (PSDs). All PGDs were in date and signed by staff authorised to administer vaccines. PSDs were in place for the health care assistant to administer vaccines.
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The practice had purchased locks for the printers to maintain prescription stationary security and had a process for monitoring these. Security of medicine storage had also been improved with items kept within in locked rooms or in tamper evident sealed boxes.
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The system for monitoring staff training had been overhauled to ensure it was kept up to date and reflected what training each staff member had completed.
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All policies within the practice had undergone a review since the last inspection. Each policy had a date for the next review identified on the policy.
- 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 we spoke with said they found it easy to get an appointment on the same day and there was continuity of care.
- 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
There were some areas where the provider continued to need to make improvements:
The provider should:
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Consider strategies for recording that cleaning of specialist equipment such as couches and blood pressure cuffs have been completed.
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Review health care waste disposal in line with best practice
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Continue to review arrangements to identify and support patients who are also carers.
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Review GP survey results including access to arranging appointments.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice