This practice is rated as Good overall. (Previous rating March 2018 – Good)

We carried out an announced comprehensive inspection at The Mortimer Medical Centre on 26 March 2018. The overall rating for the practice was good. The practice was found to be requires improvement in providing safe services. The full comprehensive report on the March 2018 inspection can be found by selecting the ‘all reports’ link for The Mortimer Medical Practice on our website at .

This inspection was an announced desk top review carried out on 7 September 2018 to confirm that the practice had carried out their plan to make the improvements that we identified in our previous inspection in March 2018. This report covers our findings in relation to those requirements and therefore this inspection is focused on the key question of safe.

Our key findings were as follows:

• There was a process in place to ensure that repeat prescriptions were signed before they were dispensed to patients in accordance with the regulations.
• The provider had reviewed and ensured there was an appropriate stock of emergency medicines available to cover potential emergency situations.
• Action had been taken to strengthen the process of the safe monitoring of medicines into monitored dosage systems.
• The process for monitoring medicines had been strengthened to ensure that patients were kept safe.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

We carried out an announced comprehensive inspection at The Mortimer Medical Practice on 26 March 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems, processes and practices in place to protect people from abuse. Staff were aware of how to raise a safeguarding concern and had access to internal leads.

• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The systems for the management of fridge temperatures was mostly managed effectively, however on the day of inspection we found that a fridge temperature was not being recorded correctly. This was immediately brought to the practice’s attention and steps were put in place to demonstrate the correct procedure. However the practice were unable to tell us how long this had been happening and so we could not be assured that the medicines in the fridge had always been kept safe. After the inspection the practice sent documentary evidence to assure us that they have reviewed their process to ensure that patients are kept safe.

• The process for issuing repeat prescriptions was not in line with current regulations. The dispensary staff were issuing repeat prescriptions which were signed by the GPs after medicines were dispensed to patients. The practice provided evidence of a procedure for this process however it did not comply with national guidance.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved treated patients with compassion, kindness, dignity and respect and the National GP Patient survey results reflected this. In addition comment cards we received reported levels of satisfaction with the services at the practice and patients we spoke with provided positive feedback.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• The practice reviewed the needs of their population and had initiated positive services for patients.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Further strengthen the process for dispensing medicines into monitored dosage systems.

• Continue to review the process for the collection of prescriptions.

• Review the system for recording fridge temperatures to ensure that patients are kept safe.

• Ensure a stock of appropriate emergency medicines are available to cover potential emergency situations.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.

Please refer to the requirement notices section at the end of this report for more details.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We inspected this practice on 16 October 2014 as part of our new comprehensive inspection programme.

The practice operates from three sites In Herefordshire, a main surgery in Kingsland and two branch surgeries, one in Orleton and one in Leintwardine. The two branch surgeries are included in the main practice’s CQC registration. We did not inspect the two branch surgeries during our inspection.

The overall rating for this practice is good. We found the practice was good in the safe, effective caring, responsive and well-led responsive domains. We found the practice provided good care to older people, people with long term conditions, people in vulnerable circumstances, families, children and young people, working age people and people experiencing poor mental health.

Our key findings were as follows:

• Patients were satisfied with how they were treated and that this was with compassion, dignity and respect. They felt the GPs listened to them and gave them enough time.
• Patients were kept safe because there were arrangements in place for staff to report and learn from key safety risks. The practice had a system in place for reporting, recording and monitoring significant events over time.
• There were systems in place to keep patients safe from the risk and spread of infection.
• The practice was responsive to the differing needs of its patient population and planned its services to meet these needs.

During our inspection we did not identify any areas where the practice was required to make improvements

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

We spoke with seven patients during our visit. All of them were very pleased with the service they received from the practice. One patient told us, “The Doctors are very good”. Another patient said that they were, “Quite happy with everything.”

We saw that the practice had policies in place to help protect patients’ privacy and dignity. The staff we spoke with were familiar with the policies. None of the patients we spoke with had any concerns in this area at all.

We found that care and treatment was planned and delivered in a way that met patients’ needs and protected their rights. Patients were able to be involved in decisions about their treatment.

We found that stocks of medicines in the practice’s dispensary were correctly stored, and recorded. We also found that medicines were safely dispensed.

We were satisfied that the provider made all the appropriate checks on staff before their full employment started. The practice manager regularly checked to ensure that healthcare professionals at the practice were correctly registered with their appropriate professional body.

We saw that the practice carried out a range of audits on a regular basis to monitor the quality of its own performance and to learn from any mistakes made. The practice had an active and effective patient participation group.