21 October 2014
During an inspection looking at part of the service
We carried out a focused inspection on 21 October 2014 to follow up on concerns we found when we last inspected the practice in May 2014.
We found that improvements had been made to the arrangements for protecting patients and staff against the risk of infections. The practice looked visibly clean and the flooring in the doctor’s consultation rooms and the nurse’s treatment room had been replaced. All staff had undertaken infection control training. The practice had an infection control policy and procedure in place and infection control checklist had been completed. However the policy and procedure was incomplete and did not identify the clinical and non-clinical staff responsible for cleaning or overseeing and monitoring the infection control practices. The policy did not include any information or guidance around dealing with bodily fluids such as blood and urine samples, managing and disposal of sharps or contaminated materials, dealing with needle-stick injuries. The audit checklist was incomplete. Questions within the checklist around waste handling, body fluid spillage and decontamination of equipment were not completed. We saw that where the checklist identified areas for action and improvements that there was no plan for addressing these
We found that improvements had been made to protect patients and staff against the risks of unsafe or unsuitable premises. The practice had arrangements in place for dealing with an outbreak of fire. A fire risk assessment checklist was carried out in July 2014. The assessment identified people who may be at particular risk in the event of a fire such as lone working staff, disabled, elderly or very young patients. All staff had undertaken fire safety training and were aware of the fires safety and evacuation procedures. Fire detection and safety equipment including fire alarms, emergency lighting and fire extinguishers were tested regularly to ensure that they were safe and in good working order.
We found that improvements had been made in supporting staff to deliver safe and effective patient care and treatment. All staff had undertaken an appraisal of their roles and performance. Staff working at the practice had undertaken training in emergency life support, fire safety and infection control. Where the appraisal system had identified areas for staff development and training there were no plans in place to show how staff were to be supported in achieving this training.
The practice did not have arrangements in place for monitoring and improving the quality and safety of the services provided. Checklists for identifying risks within the practice were incomplete and where areas for improvements were identified there were no plans in place for addressing these issues. Checks in respect of fridge temperatures used for the storage of medicines such as vaccines and checking the expiry date of medicines were not consistently carried out or monitored.