Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stonyhill Medical Practice on 3 October 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the October 2016  inspection can be found by selecting the ‘all reports’ link for Stonyhill Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 21 April 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 3 October 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:

• Significant event meetings ensured reviews of actions taken were monitored and trends were analysed. We also saw evidence that the actions taken in relation to safety alerts were now actively reviewed.

• Arrangements for safeguarding reflected relevant legislation and local requirements. The policies now clearly outlined who to contact for further guidance if staff had concerns about a patient’s welfare. Staff had received training on safeguarding children and vulnerable adults relevant to their role.

• Practice specific policies had been reviewed and updated.

• There was now an effective overview of staff training.

• All staff who acted as chaperones were now trained for the role and had received a Disclosure and Barring Service (DBS) check.

•  All staff had completed infection control training relevant to their role.

• There were now

  systems in place to monitor the use of blank prescriptions.

• We saw evidence of a program of continuous clinical audit

  which demonstrated improvements to care and treatment which were implemented and monitored.

• Administrative staff were now aware that incoming clinical post should be seen by a GP.

• The practice now offered new patient health checks to all patients

• Appropriate arrangements for identifying, recording and managing risks, issues and implementing mitigating actions were in place.

  A planned date was in place for portable appliance testing to ensure equipment was safe to use.

There were areas of practice where the provider should make further improvements. 

The provider should:

• Review the practice recruitment policy.

• Continue to monitor protected learning time for staff to conduct training and other tasks

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 Stonyhill Medical Practice on 3 October 2016. Overall the practice is rated as requires improvement.

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

• Staff were clear about reporting incidents, near misses and concerns but there was no evidence that actions taken as a result of those incidents were reviewed in a timely way.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Audits were conducted but there was no evidence of reaudits to ensure improvements had been made and were effective.
• 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 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.

• There was no mandatory training programme for staff and no evidence of training in key areas such as safeguarding, infection control or chaperones. There was no overview of staff training.

• Risks to patients were not always assessed and well managed.
• 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:

• Implement systems to ensure staff are appropriately trained and updated for their roles.

• Ensure that policies and procedures available to staff are relevant and updated as required.

• Implement systems to ensure safety alerts and actions identified from significant events have been actioned in a timely manner.

• Undertake two cycle audits to ensure improvements to care and treatment have been achieved.

• Carry out risk assessments to ensure the safety of staff and patients in particular in the areas of; staff acting as chaperones, electrical appliance testing, emergency medication, doctor’s bags and lone working outside of the practice.

The areas where the provider should make improvement are:

• Put systems in place so that all items of communication received by the practice were seen by the GPs or senior clinical staff before being filed.

• The practice should follow its recruitment policy and obtain references for all new staff employed.

• Ensure there is a system to log the use of black prescriptions

• Offer health checks to all newly registered patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice