Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hildenborough & Tonbridge Medical Group on 21 November 2016. The overall rating for the practice was good. The practice was rated as requires improvement for providing safe services and rated as good for providing effective, caring, responsive and well-led services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Hildenborough & Tonbridge Medical Group on our website at www.cqc.org.uk.

This inspection was an announced focused inspection conducted on 7 September 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 in our previous inspection on 21 November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had ensured that the system for reporting and recording significant events was implemented effectively.

• Risks to patients who used services were assessed and the systems and processes to address these risks ensured patients were kept safe. In particular, the risks associated with medicines management, as well as infection prevention and control.

The practice had also taken appropriate action to address areas where they should make improvements:

• Dispensing Standard Operating Procedures (SOPs) had been signed by all relevant staff.

• Action had been taken to ensure that cold chain storage and medicine safety alerts were appropriately recorded.

• Dispensing errors and near misses were being recorded by dispensary staff in order to enable learning.

• Processes had been revised in order to ensure that minutes of meetings were detailed and demonstrated accountability.

• The programme of clinical audits had been further developed and was being monitored.

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 Hildenborough and Tonbridge Medical Group on 21 November 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 a system for reporting and recording significant events.
• Risks to patients were not always assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills and knowledge 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. 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 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:

• Ensure that systems and processes are implemented or reviewed, in order to ensure the safe management of medicines and associated prescriptions.
• Ensure that the cleaning of the practice meets the criteria as specified in The Health and Social Care Act 2008, Code of Practice on the prevention and control of infections and related guidance.
• Ensure that all staff are aware of the process and policy for reporting and managing significant events. As well as ensuring that records are maintained in a thorough manner and demonstrate accountability.

The areas where the provider should make improvement are:

• Continue to ensure that dispensing Standard Operating Procedures (SOPs) are signed by staff.
• Continue to ensure that action taken relating to cold chain storage and medicine safety alerts are appropriately recorded.
• Continue to ensure that dispensing errors and near misses are recorded by dispensary staff to enable learning.
• Revise processes in order to ensure that minutes of meetings are detailed and demonstrate accountability.
• Continue to ensure that the programme of clinical audits is further developed and monitored.

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 Hildenborough & Tonbridge Medical Group on 21 November 2016. The overall rating for the practice was good. The practice was rated as requires improvement for providing safe services and rated as good for providing effective, caring, responsive and well-led services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Hildenborough & Tonbridge Medical Group on our website at www.cqc.org.uk.

This inspection was an announced focused inspection conducted on 7 September 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 in our previous inspection on 21 November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had ensured that the system for reporting and recording significant events was implemented effectively.

• Risks to patients who used services were assessed and the systems and processes to address these risks ensured patients were kept safe. In particular, the risks associated with medicines management, as well as infection prevention and control.

The practice had also taken appropriate action to address areas where they should make improvements:

• Dispensing Standard Operating Procedures (SOPs) had been signed by all relevant staff.

• Action had been taken to ensure that cold chain storage and medicine safety alerts were appropriately recorded.

• Dispensing errors and near misses were being recorded by dispensary staff in order to enable learning.

• Processes had been revised in order to ensure that minutes of meetings were detailed and demonstrated accountability.

• The programme of clinical audits had been further developed and was being monitored.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice