Archived: Auckley Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 9 February 2016. Breaches of legal requirements were found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to the regulatory breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014 Regulation 12 Safe care and treatment, Regulation 15 Premises and equipment and Regulation 17 Good governance.

We undertook this focused inspection on 27 July 2016 to check that they had followed their plan and to confirm that they now met the 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 for Auckley Surgery on our website at www.cqc.org.uk.

Overall the practice is rated as Good.

Specifically, following the focused inspection we found the practice to be good for providing safe and well-led services.

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

• Systems and processes were in place to keep people safe. For example, we were shown the procedure to dispense new medicines which had been reviewed in May 2016 along with the repeat prescribing procedure. All repeat prescriptions were now signed by the GP before the medicines were prepared and dispensed to the patient. A stock list of all medicines in the dispensary was now kept electronically.
• We reviewed a personnel file for a member of staff starting at the practice in since our last inspection. We found appropriate recruitment checks had been undertaken.
• A fire risk assessment had been completed following our comprehensive inspection in February 2016 and we saw evidence actions identified were completed. A fire evacuation drill had been undertaken and were now scheduled at six monthly intervals. All electrical items had now been tested for electrical safety and we observed unused plug banks and redundant electrical cables had been removed.
• The GP and practice manager had reviewed the governance framework to support performance and deliver good quality patient care.The practice had reviewed their record management procedures. 

The areas where the provider should make improvement are:

• Record actions taken by staff as part of the legionella risk assessment in a timely fashion.

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 Auckley Surgery on 9 February 2016. Overall the practice is rated as requires improvement.

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.
• Some risks to patients were assessed and managed. Others were not fully assessed and well managed. For example, fire safety, recruitment, legionella and storage of substances hazardous to health.
• We asked to see an up to date fire risk assessment and we were told one had not been completed. We shared our concerns with the local Fire Safety Officer. Following the inspection the practice shared with us a fire risk assessment completed on 11 February 2016. Staff told us they carried out regular fire drills and the fire safety equipment had been risk assessed in January 2016.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• There was a 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.
• Record management was not always sufficient. For example, we observed some paper patient records stored in an unlocked room accessible to the general public.

The areas where the provider must make improvement are:

• Ensure the actions identified in the fire risk assessment of the premises following our visit are implemented in accord with the findings.
• Ensure substances hazardous to health and patient paper records are stored securely.
• Ensure all prescriptions are signed by the prescriber prior to dispensing the medicine to the patient.
• Ensure prescription pads are tracked through the practice.
• Obtain a copy of the legionella risk assessment and electrical circuit board assessment and ensure actions identified are implemented in accord with the findings.

In addition the provider should:

• All relevant staff should complete level one safeguarding training for children as recommended in the Safeguarding Children and Young people: roles and competences for health care staff Intercollegiate document (Third edition: March 2014).
• Review the training requirements and frequency for the staff groups and document in a schedule. 
• Include the contact details of the Parliamentary Health Service Ombudsman in complaint response letters.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice