Letter from the Chief Inspector of General Practice

When we visited Newtons Practice on 30 August

2016 to carry out a comprehensive inspection we rated them as requires improvement

overall. We found breaches in the regulations relating to safe and well-led

services, and we told the practice they must:

• Ensure that medicines fridges are kept secure

  at all times.

• Ensure that health care assistants who carry

  out vaccines and immunisations do so under a clear authorisation which is

  maintained on record.

• Ensure a record of cleaning clinical areas

  and equipment is maintained to support infection control audits.

• Ensure that the feedback from patients and

  other stakeholders is managed and responded to.

We also said the practice should;

• Review and continue to take action to

  identify carers who are patients at their practice.

• Keep minutes of the regular nurse meetings to

  assist with future training, development and any quality assurance audits.

• Review the records maintained for staff

  training to ensure they are up to date.

This

inspection was an announced focused inspection carried out on 23 June 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 at

our previous inspection. This report covers our findings in relation to those

requirements and also additional improvements made since our last inspection.

This report should be read in conjunction with the full report of our

inspection on 30 August 2016, which can be found on our website at

www.cqc.org.uk.

The

practice is now rated as good overall and good for the provision of safe and

well-led services.

Our key findings were as follows:

• The practice had installed a digital lock to

  the storeroom where the medicines fridges were kept which was routinely kept

  locked.

• The practice had patient specific

  directions (PSDs) to enable the

  health care assistants to carry out vaccines

  and immunisations  under a clear

  authorisation. (PSDs are written instructions, from a qualified and registered

  prescriber for a medicine including the dose, route and frequency or appliance

  to be supplied or administered to a named patient after the prescriber has

  assessed the patient on an individual basis.) 

• The practice had reviewed their procedures for ensuring clinical areas

  and equipment was maintained and kept clean. We saw evidence of the cleaning

  tasks completed.

• The practice had reviewed and drafted a report on feedback received from

  patients. They had identified areas of action to improve their service and had

  responded to some patients feedback on the Friends and Family test website.

• The practice had reviewed how they worked to

  identify and support carers. They had a member of staff who led on this work

  and a banner and a new carers notice board in the waiting area giving further

  information for carers. They had identified 128 patients as carers which was

  approximately 0.9% of their practice list. This was a slight decrease in the

  number of carers the practice had identified at our last inspection. They had

  developed an action plan, which we saw, identifying further steps they intended

  to take such as promoting the role of carers at seasonal flu clinics.

• The practice maintained a spreadsheet to record all training attended by

  staff. This enable the practice to ensure all staff were up to date with their

  training.

We

saw one area where the provider should make improvement:

• The provider should review and continue to take action

  to identify carers who are patients at their practice.

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 Newtons Practice on 30 August 2016. Overall the practice is rated as requires improvement.

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

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• 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 not always assessed and well managed.
• 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 sought feedback from staff and patients; however it was not always acted on.
• The provider was aware of and complied with the requirements of the duty of candour.
• Medicine management practices did not always keep patients safe.

The areas where the provider must make improvement are:

• The provider must ensure that medicines fridges are kept secure at all times.
• The provider must ensure that healthcare assistants who carry out vaccines and immunisations do so under a clear authorisation which is maintained on record.
• The provider must ensure a record of cleaning clinical areas and equipment is maintained to support infection control audits.
• The provider must ensure that the feedback from patients and other stakeholders is managed and responded to.

The areas where the provider should make improvement are:

• The provider should review and continue to take action to identify carers who are patients at their practice.
• The provider should keep minutes of the regular nurse meetings to assist with future training, development and any quality assurance audits.
• The provider should review the records maintained for staff training to ensure they are up to date.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice