05 July 2016
During an inspection looking at part of the service
Letter from the Chief Inspector of General Practice
On 12th November 2015, we carried out a comprehensive inspection at Dr Jones Sr. The practice was rated as requires improvement overall, with requires improvement for safe and well-led and good for effective, caring and responsive services. The practice was issued with a requirement notice for improvement. We also made some advisory recommendations where the practice should make other improvements in the effective domain but these were not the subject of a requirement notice.
In particular, we found that improvements were required in relation to safeguarding procedures, staff awareness of Gillick consent, the training of chaperones, the monitoring of emergency medicines and reviews of patients on blood thinning treatments, the monitoring of uncollected prescriptions for vulnerable patients, clinical attendance at meetings, updates of NICE guidelines for clinical staff and the recording of complaints.
After this inspection the practice sent us an action plan that identified how they would achieve the improvements and the date when they would be completed. We then carried out an announced focused inspection at Dr Jones Sr Practice on 5th July 2016 to check that the necessary improvements had been made.
Our key findings across all the areas we inspected were as follows:
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The records of patients who were subject of safeguarding concerns were detailed. They included all relevant information and referenced where other agencies had been involved.
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Staff were aware of Gillick competency in relation to children under the age of 16 who wished to book an appointment without a parent or guardian being present.
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Staff had received chaperone training to ensure that they were equipped for the role. GPs recorded when a chaperone had been used.
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There was a system in place to monitor the expiry dates of emergency medicines in the practice and when carried by GPs when they were away from the practice.
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The practice ensured that vulnerable patients who had not collected their prescriptions were reviewed to ensure that they were not at risk of their health deteriorating.
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Nurses attended clinical team meetings.
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National Institute for Health Care Excellence (NICE) guidance was reviewed and cascaded to clinical members of staff.
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All complaints were recorded so that any trends or themes could be identified.
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Patients requiring repeat prescriptions for blood thinning medicines were appropriately monitored before a prescription was issued.
We were satisfied that the practice had made the required improvements to justify a change of rating to good for the safe and well-led domains.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice