Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Manston Surgery on 27 April 2016. We also visited the branch site in Scholes as part of our inspection. The overall rating for the practice was good. However; we rated the practice as requires improvement for providing safe care The full comprehensive report on the inspection can be found by selecting the ‘all reports’ link for Manston Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 9 March 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the issues that we identified in our previous inspection on 27 April 2016. This report covers our findings in relation to those requirements.

The practice has now met the legal requirements in the key question of safe and is now rated as good.

Our key findings were as follows:

• The practice had comprehensive Standard Operating Procedures in place to support the staff working within the dispensary at the Scholes branch site.

• The practice had a Standard Operating Procedure to cover the management of controlled drugs.

• There was a system in place to routinely check stock medicines were within expiry date and fit for use. This was supported by a Standard Operating Procedure to govern the activity.

• The practice had implemented a system to record near misses (a record of errors that had been identified and corrected before medicines had left the dispensary).

• The practice had a system in place to record and investigate incidents. We saw minutes of meetings where these had been discussed.

• There was a system in place to manage medicines safety alerts.

• The practice had a documented record of when checks were carried out on the oxygen and defibrillator.

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 Manston Surgery on 27 April 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. However; documented learning from incidents was limited.
• There were issues identified in the dispensary at the branch site. For example; staff did not keep a ‘near-miss’ record (a record of errors that have been identified before medicines have left the dispensary), standard Operating Procedures only covered basic aspects of the dispensing process and were limited in scope and detail and staff did not routinely check stock medicines were within expiry dates.
• The staff we spoke with told us that regular checks were carried out to ensure the oxygen and defibrillator had been carried out. However, saw there was no formal record documenting these checks.
• 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.
• 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 dispensing standard operating procedures are fit for purpose and cover all required processes.
• Ensure there is a system in place for identifying and sharing learning from medicines management incidents.
• Ensure that there are documented checks and records relating to medicines management to ensure the quality and safety of services

The area where the provider should make improvement are:

• Manage controlled drugs in accordance with the relevant legislation

Keep a documented record of when checks are carried out on the oxygen and defibrillator.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice