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Gade Surgery, Rickmansworth.

Gade Surgery in Rickmansworth is a Doctors/GP specialising in the provision of services relating to diagnostic and screening procedures, family planning services, maternity and midwifery services, services for everyone, surgical procedures and treatment of disease, disorder or injury. The last inspection date here was 5th April 2018

Gade Surgery is managed by Gade Surgery.

Contact Details:

Ratings:

For a guide to the ratings, click here.

Safe: Good
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2018-04-05
    Last Published 2018-04-05

Local Authority:

    Hertfordshire

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

7th March 2018 - During an inspection to make sure that the improvements required had been made pdf icon

We carried out an announced comprehensive inspection at Gade Surgery on 1 December 2016. Overall the practice was rated as good. However, we identified a breach of legal requirements. Improvements were needed to systems, processes and procedures to ensure the practice provided safe services. Consequently the practice was rated as requires improvement for providing safe services. The full comprehensive report on the December 2016 inspection can be found by selecting the ‘all reports’ link for Gade Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 7 March 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach of regulation that we identified in our previous inspection on 1 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

On this focused inspection we found that the practice had made improvements since our previous inspection and were now meeting the regulation that had previously been breached.

The practice is now rated as good for providing safe services.

Our key finding was as follows:

  • Sufficient arrangements were in place for the management of Patient Group Directions (PGDs) and they were appropriately reviewed, signed and countersigned. (Patient Group Directions are written instructions for the supply or administration of medicines to groups of patients who may not be individually identified before presentation for treatment).

Additionally where we previously told the practice they should make improvements our key findings were as follows:

  • The practice kept prescription pads securely and monitored their use.
  • Appropriate recruitment checks had been undertaken and documented prior to the employment of new staff members.
  • Actions to reduce the risks identified by the fire and Legionella risk assessments were completed and recorded. (Legionella is a term for a particular bacterium which can contaminate water systems in buildings). Water temperature checks were completed and recorded. Fire extinguishers were checked to ensure they were working properly.
  • The practice risk assessed how it transported patient identifiable data between its two sites and staff understood the precautions they needed to take to reduce the identified risks.
  • We saw that a process was in place and adhered to for monitoring the completion of staff training. Staff received training that included: adult and child safeguarding, fire safety, chaperoning and basic life support. Most of the training was provided by the use of an e-learning facility. All newly employed staff had received a training needs assessment and a process was in place to ensure all staff received one by the completion of this year’s staff appraisal process on 31 March 2018.
  • During our inspection on 1 December 2016 we found the practice’s policy for obtaining and recording patient consent for procedures was not always followed and the consent process was not monitored. During this focused inspection we reviewed the records of seven patients who had recently received joint injections, travel vaccinations or baby immunisations and found that in all the cases we looked at the appropriate consent was obtained and documented. We saw that the practice monitored the process for seeking consent to minor procedures appropriately. We looked at three quarterly audits completed between April and December 2017 which showed the 26 patients who had received a minor procedure in that time all had their consent obtained and recorded in accordance with the practice’s policy.
  • Following our inspection in December 2016 the practice had completed a piece of work to ensure its carers register (those patients on the practice list identified as carers) was correct and accurately reflected those patients who were active in a carer role. This had reduced the number of carers identified from 122 to 103. Through a proactive approach from staff this was increased and at the time of this focused inspection on 7 March 2018 the practice had identified 124 patients on the practice list as carers. This was approximately 1% of the practice’s patient list. Of those, 93 (75%) had been invited for and 22 had accepted and received a health review since 1 April 2017. Dedicated carers’ notice boards in the reception areas provided information and advice including signposting carers to support services. A member of reception staff was the practice’s carers’ lead (or champion) responsible for providing useful and relevant information to those patients and attending the relevant locality meetings.
  • Practice specific policies were implemented and were available to all staff. We looked at examples of these including the practice’s recruitment, consent, chaperoning and child safeguarding policies. We found these were regularly reviewed and updated and contained the appropriate information which reflected the practice’s current processes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

1st December 2016 - During a routine inspection pdf icon

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gade Surgery on 1 December 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed, with the exception of those relating to patient group directives.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • The practice had higher than average responses from patient feedback regarding access to the practice
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • 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, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

  • The practice must ensure that patient group directives (PGDs) are reviewed and signed by an appropriate person.

In addition the practice should:

  • Put in place a secure system for recording and monitoring the use of hand written prescription pads.
  • Continue to carry out and document legionella water testing.
  • Continue to monitor training updates for staff.
  • Ensure appropriate checks are carried out when recruiting staff and retain evidence of this in personnel files.
  • Continue to monitor the risk of transferring patient identifiable data between the branch surgery and the main practice.
  • Ensure that following external risk assessments action plans are completed in a timely manner.
  • Continue to review and update policies and procedures.
  • Continue to monitor consent process to ensure that it is adhered to by carrying out regular audits.
  • Ensure consent for procedures, including verbal consent, is documented in the patient’s notes.
  • Continue to identify and support patients who are carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

 

 

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