Archived: Rochester Road Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Rochester Road Surgery on 11 July 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the July 2017 inspection can be found by selecting the ‘all reports’ link for Rochester Road Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection on 28 September 2017 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 11 July 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• An infection control audit had been conducted to identify risks where action was required. There was an enhanced cleaning schedule for the equipment and treatment room used for minor surgery procedures.
• Emergency medicines were accessible and there was a system to check they were in date. Emergency equipment was checked monthly.
• Blank prescription forms and pads were securely stored with a system to monitor their use.
• The practice had established a system to identify, manage and mitigate infection prevention and control risks.
• Documents seen demonstrated that learning from clinical audits and significant events was shared at the practice.
• There were systems to help ensure the safety of services. For example, the recording of fire evacuation rehearsal procedures and the checking of emergency equipment.
• The practice provided the personnel file information for one GP after the comprehensive inspection on 11 July 2017, to demonstrate that they had assured themselves that the clinician was safe to practice.
• The practice had identified an increased number of patients as carers. There were 34 patients on the carers register, 1% of the patient list.

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 Rochester Road Surgery on 11 July 2017. 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 a system in place for reporting and recording significant events. However, the recording of their investigation, discussion and learning needed to be strengthened.
• Improvements were needed to minimise risks to patient safety. We found no infection prevention control audit had been conducted and the practice was unable to demonstrate they had assessed and mitigated risks.
• Some staff were not familiar with how to alert staff to an emergency. We found a medicine out of date and the practice failed to have appropriate medicines to treat a patient should they have anaphylaxis or acute severe asthma.
• Staff were aware of current evidence based guidance, but the practice would benefit from a system to ensure all clinicians were kept up to date.
• Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the practices patient survey in December 2016 showed patients reported positively on the service they received. This was confirmed in our conversations with patients and members of the patient participation group.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they were able to book an appointment within the week if not before with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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 engaged well with their patients, who told us they felt valued and listened to.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider must make improvement are:

• Ensure appropriate emergency medicines are available.
• Ensure there are systems in place to monitor the use of prescription forms.
• Establish effective systems to identify manage and mitigate infection prevention control risks.

• Evidence how learning from clinical audits and significant events is shared and improves practice.
• Establish systems to ensure the safety of services, such as the recording of evacuation rehearsal procedures and the checking of emergency equipment.
• Maintain personnel records for persons working for the practice.

The areas where the provider should make improvements are:

• Ensure the safety of prescriptions.
• Ensure staff know how to activate and respond to alarms.
• Maintain records on checks on emergency equipment and fire evacuation rehearsals.
• Evidence how they share learning from clinical audits with the clinical team.
• Improve the identification of carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice