11 April 2019
During a routine inspection
We had previously carried out an announced comprehensive inspection at Marisco Medical Practice on 28 March 2018. We rated the practice as requires improvement in safe, and responsive, good in effective and caring and inadequate in well-led. Overall the practice was rated as requires improvement. We rated all the population groups as requires improvement as the identified areas of concern affected all population groups.
This inspection, on 11 April 2019, was conducted to ensure that concerns that we had identified at our previous inspection on 28 March 2018 had been resolved.
At the inspection on 28 March 2018 the areas where the provider was required to make improvements were;
- The complaints system was not effective and did not provide a mechanism for capturing all complaints or facilitate learning from complaints to be cascaded to staff.
- There was no effective infection prevention and control process in place.
- The practice had not acted upon the advice of independent health and safety advisors and had failed to address and rectify a potentially serious patient safety issue.
- The systems in place to monitor and ensure staff received essential and training relative to their job role was ineffective.
- The temperature of refrigerators was not effectively monitored to ensure the efficacy of medicines stored within.
- Blank prescription stationary was not kept securely.
- Patient group directions did not meet the standard to allow nurses to administer medicines in line with the legal requirements.
- Feedback from patients showed that appointment systems were not working well.
In addition, we identified areas where the provider should make improvements;
- Improve the availability of non-urgent appointments.
- Undertake pro-active engagement with patients as a means of assessing patient satisfaction with the service with reference to access to clinicians.
- Update health and safety posters to show the correct contact details.
- Update the whistleblowing policy.
- Cease the practice of recording complaints in patient’s clinical notes.
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At this inspection on 11 April 2019 we found that the provider had satisfactorily addressed these concerns and the practice is now rated as good in the safe, caring, responsive and well-led key questions. It is rated as requires improvement in the effective key question. It is rated as good overall. All population groups are rated as good.
However, the practice should;
- Review and embed the process of recording patient consent to surgical procedures, and the system in place for dealing with tissue samples sent for histology.
- Ensure that medicines are prescribed in line with the latest guidance.
- Continue to monitor and assess patient satisfaction in respect of appointment availability and type.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care