Letter from the Chief Inspector of General Practice

We carried out an announced follow-up inspection at Burnham & Berrow Medical Centre on 12 April 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 and to check if improvements had been made in response to our previous comprehensive inspection on 22 June 2016.

On 22 June 2016 we found the practice required improvement in the safe domain and was rated by us as good for effective, caring, responsive and well-led domains. The overall rating for the practice was good. We issued a requirement notice with regards to the breach of Regulation 12 of the Health and Social Care Act (Regulated Activity) Regulations 2014, Safe care and treatment. The requirement notice was for the provider to make improvements to ensure:

• Patient Group Directions (PGD) that had been adopted by the practice to allow nurses to administer medicines were appropriately authorised to allow individual named health professionals to practise under the PGD.

• Fridges that were used to store medicines were subject to safe storage procedures to ensure that vaccines were stored within the appropriate temperature range and a cold chain maintained.
• All blood test results were to be viewed by a GP in a timely way in order to do all that is reasonably practicable to mitigate the related risks.
• Necessary actions were to be taken to identify and record risks regarding the absence of paediatric defibrillator pads at Berrow Medical Centre.

In addition we told the provider they should:

• Improve the care planning for patients experiencing poor mental health (including people with dementia) by incorporating information from the relevant mental health team as well as the activity of the practice into individual care plans.
• Review and follow practice policy regarding recruitment checks prior to employment of new staff.

The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Burnham & Berrow Medical Centre on our website at www.cqc.org.uk.

Overall the practice is now rated as Good.

Our key findings across the areas we inspected on 12 April 2017 were as follows:

• Patient Group Directions (PGD) that had been adopted by the practice to allow nurses to administer medicines were appropriately authorised to allow individual named health professionals to practise under the PGD.
• Fridges that were used to store medicines were subject to safe storage procedures to ensure that vaccines were stored within the appropriate temperature range and a cold chain maintained.
• All blood test results were viewed by a GP in a timely way in order to do all that is reasonably practicable to mitigate the related risks.
• Necessary action had been taken to identify and record risks regarding the use of defibrillator pads for life-threatening abnormal heart rhythms.
• Systems were in place to code and incorporate care plans for patients experiencing poor mental health (including people with dementia) into patient records.
• There was a system to ensure appropriate recruitment checks such as references had been undertaken prior to employment.

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 follow-up inspection at Burnham & Berrow Medical Centre on 12 April 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 and to check if improvements had been made in response to our previous comprehensive inspection on 22 June 2016.

On 22 June 2016 we found the practice required improvement in the safe domain and was rated by us as good for effective, caring, responsive and well-led domains. The overall rating for the practice was good. We issued a requirement notice with regards to the breach of Regulation 12 of the Health and Social Care Act (Regulated Activity) Regulations 2014, Safe care and treatment. The requirement notice was for the provider to make improvements to ensure:

• Patient Group Directions (PGD) that had been adopted by the practice to allow nurses to administer medicines were appropriately authorised to allow individual named health professionals to practise under the PGD.

• Fridges that were used to store medicines were subject to safe storage procedures to ensure that vaccines were stored within the appropriate temperature range and a cold chain maintained.
• All blood test results were to be viewed by a GP in a timely way in order to do all that is reasonably practicable to mitigate the related risks.
• Necessary actions were to be taken to identify and record risks regarding the absence of paediatric defibrillator pads at Berrow Medical Centre.

In addition we told the provider they should:

• Improve the care planning for patients experiencing poor mental health (including people with dementia) by incorporating information from the relevant mental health team as well as the activity of the practice into individual care plans.
• Review and follow practice policy regarding recruitment checks prior to employment of new staff.

The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Burnham & Berrow Medical Centre on our website at www.cqc.org.uk.

Overall the practice is now rated as Good.

Our key findings across the areas we inspected on 12 April 2017 were as follows:

• Patient Group Directions (PGD) that had been adopted by the practice to allow nurses to administer medicines were appropriately authorised to allow individual named health professionals to practise under the PGD.
• Fridges that were used to store medicines were subject to safe storage procedures to ensure that vaccines were stored within the appropriate temperature range and a cold chain maintained.
• All blood test results were viewed by a GP in a timely way in order to do all that is reasonably practicable to mitigate the related risks.
• Necessary action had been taken to identify and record risks regarding the use of defibrillator pads for life-threatening abnormal heart rhythms.
• Systems were in place to code and incorporate care plans for patients experiencing poor mental health (including people with dementia) into patient records.
• There was a system to ensure appropriate recruitment checks such as references had been undertaken prior to employment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We visited both the Burnham on Sea and Berrow sites and met with staff and patients. We heard from staff the service was well led and “had good team work, everyone is valued.” Patients we spoke with all told us they would recommend the surgery to other patients. We heard “the doctor was very nice and listened to me."

We read the audits of clinical practice which the surgery undertook to ensure the treatment was effective for patients. Patients told us “the telephone triage system means I can have a telephone consultation with the GP, and sometimes this is enough.”

We found the practice had processes in place which kept patients safe and protected them against abuse. The surgery had equipment available to support patients in an emergency.

Patients told us the surgery was responsive to their needs. We were told “I had an emergency, so I phoned up and got an appointment straight away.” We were also told “I was referred for specialist care and I didn’t have to wait any time at all.” We saw there were processes in place which assessed the quality of the service and allowed change to be implemented when needed.