Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Fenny Compton Surgery on 5 December 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice discussed learning outcomes at meetings and improved their processes where necessary.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Care and treatment were delivered in accordance with evidence- based guidelines.
• Prescriptions were signed by the issuing GP in line with national guidance.
• The system for receiving, actioning and tracking medicine related interaction alerts ensured that GPs were aware of current guidance.
• Patients said that staff involved them and treated them with compassion, kindness, dignity and respect.
• Patients reported that they found it straightforward to use the appointment system and said that they were able to access care when they needed it. Routine appointments were available within 48 hours.
• The practice achieved maximum points in the Quality and Outcomes Framework 2016/17.
• Feedback from patients was consistently good in the National GP Patient Survey.
• A dispensing apprentice won the West Midland Apprentice of the Year award.
• The practice had arranged four patient evenings in the last two years, which patients said were very popular. For example, one topic was men’s health awareness.
• The practice actively engaged with the local community. For example, patient education evenings had been held and a Christmas fair.
• GPs provided training in first aid to local community groups for children.
• Oversight in the dispensary was in the process of being tightened after the recent appointment of a dispensary manager. We found that processes were in place, but not effective. For example, the controlled drug (CD) stock held did not match the CD register entries at either the main practice or the branch site and there was no evidence of regular stock checks of CDs. A significant event was raised immediately after the inspection.
• There was a separate room for preparing dosette boxes (weekly/daily pill box organiser), which enabled the work to be done in a quiet space.
• Prescription stationery was not tracked.
• Two refrigerators were overfull, which meant that there was a risk that air could not circulate freely to control the temperature effectively.
• The cold chain arrangements for medicines in transit did not include monitoring the temperature.
• A mercury thermometer had been discarded in a standard clinical waste bin, although mercury was classed as hazardous waste.
• The practice leadership team was keen to adopt new methods of working.

The area where the provider must make improvements as they are in breach of regulations is:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Track prescription stationery at both sites.
• Review the cold chain arrangements for medicines in transit.
• Review training for discarding all types of clinical waste.

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 Fenny Compton Medical Practice on 2 September 2015. Overall the practice is rated as good. We did find some concerns around medicines management.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 and acted on this.

There were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure that prescriptions are signed by the issuing GP before the dispensing process takes place in line with national guidance.
• Discuss medicine related interaction alerts with the prescribing GP

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice