Letter from the Chief Inspector of General Practice

We carried out a previous announced inspection of this practice on 23 February 2016. Overall, we rated the practice as good. However, a breach of legal requirement was found. This related to a failure to maintain the cold-chain for medicines requiring refrigeration. Also, some medicines had not been securely stored. After the comprehensive inspection the practice wrote to us to say what they would do to address the breach we identified.

We undertook this announced focussed inspection, on 17 August 2016, to check that the practice had followed their plan and to confirm that they now met legal requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Coquet Medical Group on our website at www.cqc.org.uk.

Our key findings were as follows:

The provider had complied with the requirement notice we set following our last inspection visit. In particular, we found:

• Improvements had been made to the arrangements for monitoring vaccines. These included improved stock control arrangements and the use of appropriate validated cool boxes to transport vaccines. The provider had introduced an effective system which ensured that daily vaccine temperature checks were consistently carried out. Improved record keeping meant staff were able to demonstrate when vaccines were stored at the recommended temperature, and that they had taken appropriate action when they were not. Staff had received training to help maintain the improvements introduced.

• Action had been taken which ensured that all medicines kept at the practice were securely stored, to prevent unauthorised access.

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 Coquet Medical Group on 23 February 2016. Overall the practice is rated as good.

Our key findings were as follows:

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG).
• Information about services and how to complain was available and easy to understand.
• Patients said they were able to get an appointment with a GP when they needed one, with urgent appointments available the same day.
• Extended hours surgeries, with GPs and nurses, were offered at both sites every Saturday morning.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff had received training appropriate to their roles.
• There was a clear leadership structure in place and staff felt supported by management. The practice proactively sought feedback from staff and patients, which they acted on.

• Staff throughout the practice worked well together as a team.

We saw some areas of outstanding practice including:

• The practice had engaged with a national cancer charity to help promote and further increase the uptake of cervical smears. This involved sending out ‘pink letters’ to those patients who had not responded to previous invites, asking them to book an appointment. Since November 2015, 65 pink letters had been sent out and a total of 18 patients who had not previously responded to invites had received the test.

• The practice had proactively engaged with a national diabetes charity to provide a support group for patients. The nearest group was over 25 miles away and was not convenient for patients. One of the GP partners worked with a member of the administrative team to organise a local meeting. An initial meeting was well attended; subsequent events were held in bigger premises to allow more people to attend.

However, there was also an area of practice where the provider needs to make improvements.

Importantly, the provider must:

Ensure appropriate arrangements are in place:

• to maintain the cold chain for medicines requiring refrigeration.

• to securely store medicines.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

We spoke with seven patients. We found most people were very happy with the service provided. People spoke positively about the staff at the practice and the care and support they received from the doctors. They said their dignity and privacy was respected. Most people felt they were able to get an appointment when they needed one although none of the people we spoke to were aware of the doctor’s triage system for arranging appointments or telephone contact at short notice. One person told us staff usually answer the phones quite quickly and they offer different times and dates.

People were generally very satisfied with the care provided at Coquet Medical Group. They spoke highly of the professionalism and commitment of the staff. One person said, “This is the best practice I have been to.”

There were safeguarding policies and procedures for both children and vulnerable adults. One of the doctors was the identified lead for safeguarding and staff were clear about actions to be taken when concerns were identified. We found the practice was clean and tidy with effective systems in place to reduce the risk and spread of infection.

There were arrangements in place to ensure staff recruitment was well managed and all appropriate checks were carried out before new staff started work.