Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Chestnuts Surgery on 26 July 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for The Chestnuts Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 14 February 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 26 July 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 revised the system that managed and recorded actions taken as the result of receiving national patient safety alerts.

• The practice was able to demonstrate that risks to patients, staff and visitors were being assessed and well managed.

• The practice had revised clinical audit activity to help ensure it was driving quality improvement.

• The practice had made improvements to help ensure staff maintained accurate, complete and contemporaneous records in respect of each service user.

• The practice had introduced systems to help ensure results were received for all samples sent for the cervical screening programme as well as to help ensure women who were referred as a result of abnormal results were followed up.

• The practice had introduced a system that identified patients who were also carers. The practice had identified 28 patients on the practice list who were also carers.

• Governance arrangements had been revised to help ensure they were effectively implemented.

• The practice had introduced a system to help keep all governance documents up to date.

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

In addition the provider should:

• Continue to identify patients who are also carers to help ensure eligible patients are offered relevant support.

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 The Chestnuts Surgery on 26 July 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for The Chestnuts Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 14 February 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 26 July 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 revised the system that managed and recorded actions taken as the result of receiving national patient safety alerts.

• The practice was able to demonstrate that risks to patients, staff and visitors were being assessed and well managed.

• The practice had revised clinical audit activity to help ensure it was driving quality improvement.

• The practice had made improvements to help ensure staff maintained accurate, complete and contemporaneous records in respect of each service user.

• The practice had introduced systems to help ensure results were received for all samples sent for the cervical screening programme as well as to help ensure women who were referred as a result of abnormal results were followed up.

• The practice had introduced a system that identified patients who were also carers. The practice had identified 28 patients on the practice list who were also carers.

• Governance arrangements had been revised to help ensure they were effectively implemented.

• The practice had introduced a system to help keep all governance documents up to date.

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

In addition the provider should:

• Continue to identify patients who are also carers to help ensure eligible patients are offered relevant support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Training and guidance was in place along with checks to establish suitability to work with vulnerable people and children to help protect people using the service.

Medicines were managed safely. Processes were in place to audit medicines for use in an emergency, and prescription pads were kept securely with systems in place to identify missing prescriptions.

We found that people’s individual needs were assessed at each visit and care and treatment was planned and delivered to maintain people’s welfare and safety. There were arrangements in place for dealing with foreseeable emergencies.

People were not fully protected from abuse because of a lack of training for staff and a lack of awareness of their roles and responsibilities in relation to abuse.

People were protected against the risks associated with infection because appropriate procedures were followed by the staff.

Medicines were not always kept safely, and the processes to ensure the security of medicines and prescription pads had not been risk assessed.

There were robust and effective systems for assessing and monitoring the quality of the service. People’s views were sought and acted upon .