Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Grange Road Surgery

on 24 November 2015. Following our comprehensive inspection overall the practice was rated as good with requires improvement for the safe domain. Following the inspection we issued a requirement notice. The notice was issued due to a 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 practice to implement the necessary changes to ensure patients who used the service were protected against any risks associated with the safe management of the medicines, checking of emergency equipment and the safe management of blank prescriptions. A copy of the report detailing our findings can be found at www.cqc.org.uk.

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

• The areas where the provider must make improvement are:

• The practice must implement policy and procedures which reflect current best practice to ensure the safe management of the medicines, checking of emergency equipment and the management of blank prescriptions. The processes for the safety of prescriptions must be sufficiently implemented to provide a clear audit trail in the event of any security incident.

• The areas where the provider should make improvement are:

• The provider should review the layout and staffing of the reception area so that conversations between patients and the receptionist could not be overheard and reduce the wait for reception so patients did not have to queue so long.

• The practice should always involve a GP in the 6 month review of the significant events and the learning and action taken.

• The practice should identify a date for completion of actions or training in the staff had personal development plans.

• The policies and procedures should always cite the latest best practice or guidance.

We undertook this focused inspection on 25 August 2016 to follow up the requirement to assess if the practice had implemented the changes needed to ensure patients who used the service were safe.

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

• The practice had reviewed and rewritten their medicine management protocols, processes for prescription security and checking emergency equipment; these had been fully implemented by the practice.

• The front desk staffing had been reviewed and dedicated reception staff were available to focus on patients who arrived at the reception desk.

• The process for review of significant events now involved the GP team.

• We found the policies and procedure which had been compiled since our last visit made reference to best practice guidance.

• Personal development plans had been updated to include completion dates for any training or action.

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 Grange Road Surgery on 24 November 2015. Overall the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice was purpose built 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 practice were proactive in ensuring the facilities were reviewed and fit for purpose and had made application to NHS England and the Primary Care Infrastructure Fund for new premises.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• The practice worked collaboratively with three other practices in the area to fund a patient champion to liaise with patients for feedback, undertake health promotion and inform patients about local services.

The areas where the provider must make improvement are:

• The practice must implement policy and procedures which reflect current best practice to ensure the safe management of the medicines, checking of emergency equipment and the management of blank prescriptions. The processes for the safety of prescriptions must be sufficiently implemented to provide a clear audit trail in the event of any security incident.

The areas where the provider should make improvement are:

• The provider should review the layout and staffing of the reception area so that conversations between patients and the receptionist could not be overheard and reduce the wait for reception so patients did not have to queue so long.
• The practice should always involve a GP in the 6 month review of the significant events and the learning and action taken.
• The practice should identify a date for completion of actions or training in the staff had personal development plans.
• The policies and procedures should always cite the latest best practice or guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice