We carried out a focussed responsive inspection of Scarborough Medical Group on 23 May 2019. This inspection was in response to concerns raised anonymously with the Care Quality Commission. During this inspection we inspected the areas highlighted to us as concerns, which were in the safe domain only.

We inspected the main surgery, Danes Dyke Surgery, 463a Scalby Road, Scarborough, North Yorkshire, YO12 6UB. We also inspected the branch sites, South Cliff Surgery, 56 Esplanade Road, Scarborough, North Yorkshire, YO11 2AU and Cloughton Village Surgery, 1 Station Lane, Cloughton, North Yorkshire, YO13 0AD. Danes Dyke Surgery and Cloughton branch surgery are both dispensing surgeries.

The service had previously been inspected on 6th November 2014 and was rated as good across all domains and populations groups.

This report covers our findings in relation to the areas raised as concerns only.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and

information from the provider and other organisations.

We have rated this practice as good in the safe domain.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• The systems and processes in place to keep children safe and safeguarded from abuse required improvement. Following the inspection, we were provided with evidence that the issues identified had been rectified.

Our key findings were as follows;

• The inspection highlighted a problem with access to safeguarding children information on the computer system for certain clinicians. We were shown evidence that this was rectified and shared in the wider locality to ensure it was not happening elsewhere.
• Safeguarding multi-disciplinary team meetings were not routinely held and the safeguarding children register was not up to date. Following the inspection, we were shown evidence that the practice had organised multi-disciplinary team meetings to discuss safeguarding issues and updated the child safeguarding register.
• Recruitment and induction checks were carried out in accordance with regulations.
• Premises, equipment and health and safety records were all up to date.
• Appropriate standards of cleanliness and hygiene were met and there was an action plan in place for any infection prevention and control issues identified by audit.
• Staff we spoke with were aware of their duty to maintain patient confidentiality and were up to date with information governance training.
• The practice had systems for the appropriate and safe use of medicines, including medicines optimisation.
• Dispensary services had standard operating procedures and staff who dispensed were appropriately trained for the role.

Whilst we found no breaches of regulations, the provider should:

Monitor the safeguarding children procedures that have been implemented to ensure they become embedded into practice.

Ensure that patient records are stored in lockable cabinets/rooms.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Scarborough Medical Group on 6 November 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, safe, effective, caring and responsive services that met the needs of the population it served.

Our key findings were as follows:

• Patients who use the service were kept safe and protected from avoidable harm. The building was well maintained and clean.

• All the patients we spoke with were positive about the care and treatment they received. The CQC comment cards and results of patient surveys showed that patients were consistently pleased with the service they received.

• There was good collaborative working between the practice and other health and social care agencies that ensured patients received the best outcomes. Clinical decisions followed best practice guidelines.

• The practice met with the local Clinical Commissioning Group (CCG) to discuss service performance and improvement issues.

• There were good governance and risk management measures in place. The leadership team were visible and staff we spoke with said they found them very approachable.

We saw an area of outstanding practice:

• The practice undertook thorough investigations of significant events using a root cause analysis approach, this involved looking at system failures as well as individuals. This had resulted in the development of a service so patients on warfarin (a medicine that thins the blood) could have their blood test done at the practice which had resulted in the reduction of incidents related to patients taking the wrong dose of warfarin.

However, there were also areas of practice where the provider needs to make improvements.

In addition the provider should:

• Ensure there is an audit trail of blank prescriptions forms.
• Ensure monitoring checks for health and safety and infection control are documented.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice