Deepcar Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Deepcar Medical centre on 14 December 2016. The overall rating for the practice was good with requires improvement in safe. The full comprehensive report from 14 December 2016 can be found by selecting the ‘all reports’ link for Deepcar Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 9 May 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 in our previous inspection on 14 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated good. Specifically, following the focused inspection we found the practice to be rated good for providing safe services.

Our key findings were as follows:

• The practice had implemented standard operating procedures for staff to follow in the dispensary to ensure all prescriptions were signed by a GP prior to medication being dispensed.
• Standard operating procedures in the dispensary had been reviewed and updated to include monitoring of uncollected dispensed medication.
• The practice had implemented a system to monitor and track blank prescriptions on receipt into the practice in accordance with NHS Protect Security of Prescriptions Guidance 2013.
• The practice had introduced a system of ‘near miss’ recording in the dispensary to identify trends and patterns in errors and to take action to prevent reoccurrence.
• The practice maintained a complete record of the immunity status of clinical staff as specified in the national Green Book (immunisations against infectious disease) guidance for healthcare staff.

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 Deepcar Medical Centre on 14 December 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.
• Risks to patients were assessed and well managed. However, there were some shortfalls in the processes and systems for dispensing medication which required improvement.
• 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.
• Feedback from patients about their care was consistently positive. Patients told us staff were very caring and said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• 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.
• 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.

We saw areas of outstanding practice:

• The practice had hosted in recent months two coffee mornings at the practice which had been well attended by patients, carers and members of the patient participation group to support local charities. They had used these events to specifically invite patients who were carers and patients who may be vulnerable or isolated. Practice staff baked cakes and provided snacks for the events. Entertainment was also provided through quizzes, bingo and raffles. Support services including representatives from charities and the community support worker were invited to attend to provide advice and signposting to services. For example, the local social café held at the local church. The practice manager told us they received very positive feedback from patients and carers on how it had supported them to engaged with others in similar situations and also to find out about support groups and what is happening in the local community.

• The practice worked proactively with other social care providers by identifying patients who required extra social support and had made referrals to other agencies on the patient’s behalf. For example, Age UK, the local social café and the Sheffield Drinkwell Agewell support group. The practice also hosted a community support worker who would advise and signpost patients to services. For example, information on housing and social care or support to join local social activities. The staff we spoke with proactively referred patients to this service and told us of specific instances where they had referred patients who had approached them directly for help. For example, the receptionist had referred a patient with no access to food and who was going to be made homeless to the community support worker who was able to assist with food vouchers and accommodation.

The areas where the provider must make improvement are:

• Implement a procedure to ensure all prescriptions are signed by a GP prior to medications being dispensed..
• Ensure Standard Operating Procedures (SOPs) in the dispensary are available to all dispensary staff, cover all the procedures and updates are shared with staff.
• Implement a system to record receipt of blank prescription forms into the practice in accordance with NHS Protect Security of prescription guidance 2013.

The areas where the provider should make improvement are:

• Maintain a complete record of the immunity status of clinical staff as specified in the national Green Book (immunisations against infectious disease) guidance for healthcare staff.
• Introduce a system of “near miss” recording in the dispensary.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice