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Archived: Dr CJ George

Reports


Inspection carried out on 21 August 2018

During an inspection to make sure that the improvements required had been made

We carried out an announced comprehensive inspection of Dr CJ George on 7 December 2017. The service required improvement for safe, responsive and well-led services. The full comprehensive report on the December 2017 inspection can be found by selecting the ‘all reports’ link for Dr CJ George on our website at www.cqc.org.uk.

We carried out an announced focused inspection on 21 August 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 7 December 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

At our last inspection 7 December 2017 we found:

  • There was no systematic approach for reporting and recording significant events which complied with the Duty of Candour Regulation.
  • Staff and doctors did not understand their responsibilities regarding safeguarding of adults and children.
  • There was no assessment of the risk of Legionella at the premises.
  • There was no assessment of the risk of not having a defibrillator or medical oxygen on the premises.
  • Practice policies were not reviewed to reflect current legislation and best practice.
  • There was no system for recording and actioning any relevant patient safety alerts.
  • There were no appropriate physical checks of the fitness for purpose, of the building and equipment such as electrical, fire safety and clinical products.
  • There was no effective system for managing and responding to complaints.

We checked these areas as part of this focussed inspection and found these had been resolved.

This service is registered with Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Dr George some services are provided to patients under arrangements made by themselves, their employer, government departments or insurance companies. These types of arrangements, such as medicals for HGV/PCV Driving Licences, are exempt by law from CQC regulation.

Therefore, we only inspected the services subject to Regulation.

Our key findings were:

  • There was a systematic approach for reporting and recording significant events which complied with the Duty of Candour Regulation.
  • Staff and doctors understood their responsibilities regarding safeguarding of adults and children.
  • There was an assessment of the risk of Legionella at the premises and its findings acted upon.
  • There was an assessment of the risk of not having a defibrillator or medical oxygen on the premises and its findings were acted upon.
  • Practice policies were reviewed to reflect current legislation and best practice.
  • There a system for recording and actioning any relevant patient safety alerts.
  • There were appropriate physical checks of the fitness for purpose, of the building and equipment such as electrical, fire safety and clinical products.

There was an effective system for managing and responding to complaints.

Inspection carried out on 7 December 2017

During a routine inspection

We carried out an announced comprehensive inspection on 7 December 2017 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was not providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Dr George provides general health consultations, a range of vaccination services, medicines dispensing, minor operations and other medical services.

This service is registered with Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Dr George some services are provided to patients under arrangements made by themselves, their employer, government departments or insurance companies. These types of arrangements, such as medicals for HGV/PCV Licences, are exempt by law from CQC regulation. Therefore, we only inspected the services subject to regulation.

We asked for patients to complete CQC comment cards prior to the inspection. All the 26 patient comment cards we received were positive about the service experienced. Of those 10 specifically mentioned the diagnostic or listening skills of the doctor and five the caring attitude of staff in reception. There were no patients at the service at the time of the inspection.

Our key findings were:

  • There was an open and transparent approach to safety but no systematic approach for reporting and recording significant events.

  • Staff we spoke did not demonstrate an understanding of their responsibilities regarding safeguarding. The doctor and the reception staff were not trained in safeguarding children and vulnerable adults.

  • There was no assessment of the risk of Legionella.

  • There was no defibrillator or medical oxygen on the premises.

  • Patients’ notes were comprehensive. The provider ordered timely and appropriate investigations. These were followed up. Advice to patients was clear. The reasons for the various decisions, such as medicines prescribed, were well recorded.
  • Staff told us the provider was approachable and always took the time to listen to members of staff. Most staff had been with the provider for a long time and there was no staff turnover.
  • Complaints were not comprehensively recorded.
  • There was a lack of overarching governance.

We identified regulations that were not being met and the provider must:

  • Ensure there is systematic approach for reporting and recording significant events which complies with the Duty of Candour Regulation.

  • Ensure that staff and doctors understand of their responsibilities regarding safeguarding of adults and children.

  • Ensure that there is an assessment of the risk of Legionella at the premises and its findings are act upon.

  • Ensure there is an assessment of the risk of not having a defibrillator or medical oxygen on the premises and its findings are act upon.

  • Ensure practice policies are reviewed to reflect current legislation and best practice.

  • Ensure that there is a system for recording and actioning any relevant patient safety alerts.

  • Ensure that there are appropriate physical checks, of the fitness for purpose, of the building and equipment such as electrical, fire safety and clinical products.
  • Establish and operate an effective system for managing and responding to complaints.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

  • Review staff training to identify areas for learning and development. In particular the doctor should be aware of the requirements of the Mental Capacity Act.
  • Review the security of patients’ notes.

Inspection carried out on 26 February 2014

During a routine inspection

People were very happy with the service they received from Dr George. Some comments made included �Helpful and friendly� and �A very good service�. People said that they would and had recommended the service to other people.

There were systems in place to manage cleanliness and to reduce the risk of infection at the service.

There were sufficient numbers of staff to meet people�s needs.

There were systems in place to monitor the quality of the care and treatment provided. People�s feedback about the service was positive.

There was a clear complaints policy in place and we saw that past complaints were taken seriously and investigated.

Inspection carried out on 20 March 2013

During a routine inspection

The practice was inspected by one Inspector over two hours. We found that the doctor and staff were friendly and professional, and they co-operated fully with all the requirements of the inspection. The doctor employed three staff members, two of whom were receptionists and administrators, and one person for cleaning the premises.

We found that the practice provided patients with clear information about their diagnosis and available treatments. The practice also had a website which provided full information about the service.

There were no patients present during our visit, and we obtained their views by reading feedback survey forms which had been completed during the past year. We saw that the survey results were very positive, with all the patients rating their satisfaction with the service as �excellent� or �good.�

We saw that the premises were clean in all areas, and were well presented. The doctor ensured that health and safety guidelines were followed and appropriate safety checks were carried out.

We inspected the processes for prescribing and dispensing medication, and found that there were good systems in place. These included safe storage of medication and accurately completed records.

Reports under our old system of regulation (including those from before CQC was created)