Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Range Medical Centre on the 24 November 2016. At the inspection in November 2016 the overall rating for the practice was good, although the key question safe was rated requires improvement. We found improvements were needed in relation to staff recruitment, systems to monitor expiry dates of vaccines, information governance in relation to locum staff and the management of some risks in relation to Control of Substances Hazardous to Health (COSHH) regulations. In addition we identified that not all staff files demonstrated evidence that an induction had been completed.

The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for The Range Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on the 16 March 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the two breaches in regulation that we identified in our previous inspection on 24 November 2016. This report covers our findings in relation to those requirements.

The practice is now rated good for all key questions and the overall rating remains good.

Our key findings were as follows:

• At our previous inspection in November 2016 we found some staff files did not contain all the required recruitment documentation. The practice supplied evidence to demonstrate all staff recruitment files had been reviewed and a matrix of records held for each staff member was established.
• The practice had introduced induction training record sheets for both clinical and non clinical staff and completed copies of these for both a GP and non clinical staff member were provided to demonstrate their use.
• Systems had also improved to ensure locum GPs had specific logins and passwords to use on the patient electronic record system.
• Data sheets were now available at the practice for all substances such as cleaning agents used at the practice. This ensured compliance with COSHH regulations.
• At the previous inspection in November 2016 we noted six vaccines, held in one of the practice’s vaccines fridges had passed their expiry date. The practice had reviewed their policy on the monitoring of vaccines and had improved how expired vaccines were disposed of. Records supplied demonstrated the practice’s policy was implemented appropriately.

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 Range Medical Centre on 24 November 2016. Overall the practice is rated as good.

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

• 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 effectively assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice had comprehensive policies for the recruitment of staff. However, did not always adhere to these as we found gaps in the personnel files.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 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 improvements are:

• Assess the recruitment procedures to include all necessary employment checks for all staff employed by the practice.
• Ensure systems are in place to check vaccines are monitored regularly to ensure they are not past their expiry dates.
• Ensure the arrangements for identifying, recording and managing risks and implementing the mitigating actions are fully embedded. For example, systems were not in place to ensure the Control of Substances Hazardous to Health (COSHH) regulations are being adhered to.
• Ensure locum staff log in using their own credentials to ensure traceability is maintained and to maintain information governance requirements including confidentiality.

In addition the provider should:

• Maintain evidence of staff undertaking induction in their personnel files.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice