The Care Quality Commission
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Archived: Ashlea Medical Practice Also known as Gilbert House

Overall: Good read more about inspection ratings

Gilbert House, 39 Woodfield Lane, Ashtead, Surrey, KT21 2BQ (01372) 276385

Provided and run by:
Ashlea Medical Practice

All Inspections

14 July 2015

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 5 November 2014. Breaches of legal requirements were found during that inspection within the safe domain. After the comprehensive inspection, the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:

  • Improve the security for the storage of blank prescription forms and recording the serial numbers of prescription forms in line with national guidance
  • Record all significant events and ensure that regular review meetings are documented to demonstrate that the practice had learned from these and that findings are shared with relevant staff

Our previous report also highlighted areas where the practice should improve:-

  • Record notes from reception staff meetings
  • Ensure all staff complete safeguarding for Vulnerable Adults

We undertook this focused inspection on 14 July 2015 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

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

  • Significant events were a standing agenda item in the practice meeting held every three weeks.
  • Minutes were kept of the significant events meeting discussions and reflective learning was recorded.
  • Blank prescription forms were handled in accordance with national guidance as these were tracked through the practice and kept securely at all times.
  • Records were kept of the serial numbers of blank prescriptions pads issued to the GPs and these were counter signed by the GP and the reception manager.
  • Prescription pads were stored in a lockable draw in an area where non authorised staff did not have access.
  • Most staff had completed training on safeguarding vulnerable adults and dates were in place for those that were yet to take place.
  • We saw that minutes were being kept of reception staff meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

5 November 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ashlea Medical Centre – Gilbert House on 5 November 2015. Overall the practice is rated as good.

The provider has two practice locations. Gilbert House situated in Ashtead and Linden House situated in Leatherhead. We inspected both practices separately. This report relates to Gilbert House. Linden House was inspected on 13 November 2014 the details of which can be read in a separate report.

Gilbert House provides primary medical services to people living in Ashtead. The practice is situated in a residential area.

At the time of our inspection there were approximately 9,700 patients registered at the practice with a team of five GP partners who held managerial and financial responsibility and one salaried GP. Gilbert House is a GP training practice and at the time of the inspection was providing training and support for two registrars.

The inspection team spoke with staff and patients and reviewed policies and procedures implemented throughout the practice. The practice was responsive to the needs of the local population and engaged effectively with other services. There was a culture of openness and transparency within the practice. The practice was committed to providing high quality patient care and provided support and training to staff to facilitate this. We noted that the practice was not working to national guidelines in relation to recording serial numbers of prescriptions and ensuring that blank prescriptions were securely stored. The practice is required to record significant events onto an annual summary and we saw this was not routinely being completed. GPs told us all significant events and lessons learnt were discussed during daily meetings, however, these meetings were not minuted.

Our key findings included:-

  • Patients told us they felt they were treated with respect and dignity
  • Staff were mindful of patient privacy and confidentiality was maintained.
  • Patients told us there was a wide range of appointments including urgent appointments available the same day.
  • Infection control audits and cleaning schedules were in place and the practice was seen to be clean and tidy
  • An active patient participation group was working in partnership with the practice
  • The practice had safeguarding procedures in place and means of sharing information in relation to patients who were vulnerable.

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

Importantly, the provider must:

  • Improve the security for the storage of blank prescription forms and recording the serial numbers of prescription forms in line with national guidance
  • Record all significant events and ensure that regular review meetings are documented to demonstrate that the practice had learned from these and that findings are shared with relevant staff

In addition the provider should:

  • Record notes from reception staff meetings
  • Ensure all staff complete safeguarding for Vulnerable Adults

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice