The Malago Surgery - Care Quality Commission

Background to this inspection

Updated 29 March 2017

The Malago Surgery is located in the Bedminster area of Bristol. They have approximately 9562 patients registered who come from the Bedminster, parts of Knowle West and Redcliffe areas of Bristol.

The practice operates from two locations:

40 St John's Road

Bedminster

Bristol

BS3 4JE

Branch Surgery:

BS1

Favell House

Queen Charlotte Street

Bristol

BS1 1DQ

We visited both of these locations during this and the previous inspection. The Malago Surgery is situated in an adapted residential property in Bedminster. The consulting, treatment rooms and some of the main administration areas for the practice are situated on the ground floor. There is no patient parking and a small number of parking spaces for staff. There is short stay parking in the local vicinity. BS1 is a leased surgery premises in the centre of Bristol. There are three consulting rooms/treatment rooms and a waiting area. There is on street meter parking.

The practice is made up of seven GPs in total including five partners, salaried GPs, an operational manager and the practice manager. The practice is a teaching practice with two GPs as trainers and they had one GP registrar at the time of this inspection. They have an advanced nurse practitioner, a recently employed practice nurse lead, two practice nurses and two healthcare assistants. The practice employs a full time pharmacist and emergency care practitioner. The practice is supported by an administrative team consisting of medical secretaries, receptionists and administrators.

The Malago Surgery is open from 8.30am until 6.30pm Tuesday, Thursday and Friday. On Monday the practice opens from 7am and closes at 7.30pm. On Wednesday the practice opens 8.30am and closes later at 8pm. They accept telephone calls between 08:30 - 12:30and 13:30 - 18:30. BS1 is open between the hours 8.30am to 12.45pm, Monday, Tuesday and Friday, on Wednesday and Friday the practice opens from 1.30pm to 5.45pm. On Thursdays the practice is closed and patients can attend The Malago Surgery if required.

The practice has a Personal Medical Services contract with NHS England (a locally agreed contract negotiated between NHS England and the practice). The practice is contracted for a number of enhanced services including extended hours access, patient participation, immunisations and unplanned admission avoidance.

The practice is a training practice and also offers placements to medical students and trainee GPs.

The practice does not provide out of hour’s services to its patients, this is provided by BrisDoc. Contact information for this service is available in the practice and on the practice website.

Overall inspection

Good

Updated 29 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Malago Surgery on 24 February 2016. The overall rating for the practice was requires improvement for the safe, effective, responsive and well-led domains. The practice were rated as good for caring services. The key areas of concerns found during that inspection were:

the practice did not have effective systems for infection control, had not identified a member of staff as an infection control lead and had not shown that appropriate actions were taken to address areas of concern promptly.
the practice did not have suitable arrangements in the practice for managing medicines, including emergency medicines, vaccinations, and prescription stationary to keep patients safe.
the practice did not have effective systems in place which promoted the health and safety of staff and patients at the practice.
the practice did not evidence that appropriate checks had been made and did not have the required information in regard to the locum GPs who worked at the practice.

The full comprehensive report on the February 2016 inspection can be found by selecting the ‘all reports’ link for The Malago Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection which we carried out on 13 February 2017. Its purpose was to confirm that the practice had carried out their action plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 24 February 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

the provider now had effective systems for infection control and had identified a member of staff as an infection control lead and had shown that appropriate actions were taken to address areas of concern promptly.
the provider now had suitable arrangements in the practice for managing medicines, including emergency medicines and vaccinations, and prescription forms to keep patients safe.
the provider now had effective systems in place which promoted the health and safety of staff and patients at the practice.
the provider evidenced that appropriate checks were made and had appropriate information held in regard to the locum GPs who worked at the practice.
the provider had ensured that staff had the skills, knowledge and experience to deliver safe and effective care and treatment.
the provider had implemented a safe system in place for managing complaints that ensured that they were investigated and acted upon sufficiently. Any learning from complaints was shared with staff and other stakeholders. Feedback from patients, such as comments left on NHS Choices, were responded to and acted upon
the provider had a documented business plan to support the development of the service.
there were designated leads in the staff team to manage key areas of the service provision.
practice policies had been reviewed or updated in a timely way
there were now management and governance systems for the provider to ensure there were safe systems in place for health and safety, infection control, medicines management, safe recruitment, staff training and the management of complaints.

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

In addition the provider should:

ensure that the changes made to the protocols for the management of prescription stationary in accordance with NHS England’s prescription paper management are sustained.
ensure the protocols in regard to appropriate temperature safety checks for medicines refrigerator checks are sustained.
ensure that the changes in the recruitment and management of any future GP locums employed are sustained.
ensure that there is a sustained regular fire drill and alarm check programme.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice