Archived: Dr Stephen Hilton Also known as Elvaston Road Surgery

Letter from the Chief Inspector of General Practice

(At the time of the inspection, Dr Hilton had recently retired from the practice and no longer held the contract for providing primary care services at this location. Although Dr Hilton continues to be registered with the Care Quality Commission for this location, he has submitted an application to cancel his registration. Another provider is in day-to-day control of the practice, and they are in the process of making application to add this location to their current registration.)

We carried out an announced focussed inspection of this practice on 7 December 2015 to check compliance with a requirement notice we had previously issued following our inspection of 15 January 2015. During our inspection of 7 December 2015, a continuing breach of a legal requirement was found and we issued an enforcement action.

The continuing breach we identified when we carried out the inspection on 7 December 2015 was in relation to:

• Regulation 13 HSCA 2008 (Regulated Activities) Regulations 2010 Management of medicines (which corresponds to Regulation 12 (f) & (g) of the HSCA 2008 (Regulated Activities) Regulations 2014.)

We undertook this announced focused inspection on 9 June 2016 to check whether the provider had taken steps to comply with the above legal requirement. This report only covers our findings in relation to this requirement. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Dr Stephen Hilton on our website at www.cqc.org.uk.

Our key findings were as follows:

• The provider had complied with the enforcement action we issued in relation to the arrangements for protecting patients against the risk of receiving ineffective vaccines.

• There had been a recent change of provider, and the consequent uncertainty regarding staffing arrangements, had led to the short-term loss of one weekly clinical session. This had reduced the availability of routine appointments. However, the new provider had responded appropriately and quickly, and was actively taking steps to address this situation by recruiting another GP.

The areas where the provider should make improvements are:

• Devise an adult safeguarding policy.

• The practice’s designated infection control lead should complete more advanced training to enable them to carry out this role more effectively.

• Continue to closely monitor GP staffing levels to meet patient demand for appointments.

• Re-decorate those areas of the building which are showing signs of wear and tear, i.e. walls and ceilings.

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 inspection of this practice on 15 January 2015. Breaches of legal requirements were found. Although the provider did not submit an action plan following the publication of our report of that inspection, they did tell us about the improvements they intended to make to address the breaches of legal requirements, as set out in the Health and Social Care Act (HSCA) 2008. The provider did give us an action plan during our follow up focused inspection on 07 December 2015.

The breaches we identified when we carried out the inspection on 15 January 2015 were in relation to:

• Regulation 12 HSCA 2008 (Regulated Activities) Regulations 2010 Cleanliness and infection control (which corresponds to Regulation 12 (2) (h) of the HSCA 2008 (Regulated Activities) Regulations 2014);

• Regulation 13 HSCA 2008 (Regulated Activities) Regulations 2010 Management of medicines (which corresponds to Regulation 12 (f) & (g) of the HSCA 2008 (Regulated Activities) Regulations 2014.)

We undertook this focused inspection on 7 December 2015 to check whether the provider had taken steps to comply with the above 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 Dr Stephen Hilton on our website at www.cqc.org.uk.

Our key findings were as follows:

• Improvements to patient safety had been made following our last inspection on 15 January 2015. For example, action had been taken to improve the arrangements for assessing the risk of, and controlling and preventing the spread of infection. Suitable arrangements had been made for the safe handling of prescriptions. There was a more effective system for monitoring vaccine expiry dates and we found that vaccines held at the practice were all within their expiry dates. The provider had carried out a comprehensive review of the practice’s Legionella risk assessment. A business continuity plan had been prepared and staff had been provided with access to a child protection policy.

• However, we identified further concerns that some of the arrangements for protecting patients against the risk of receiving ineffective vaccines were not always reliable or effective. For example, the arrangements for protecting vaccines requiring refrigeration during transportation and storage off site were not adequate. Ineffective arrangements had been made to carry out daily temperature checks of the vaccines stored at the practice.

  The areas where the provider must make improvements are:

• Improve the arrangements for the storage and handling of vaccines, and ensure that national guidelines are fully implemented.

The areas where the provider should make improvements are:

• Make improvements to the quality of minute taking of meetings held within the practice.

• Consider using a second thermometer to check the accuracy of the temperature readings displayed on the thermometer installed in the dispensary refrigerator. The provider should also arrange for annual calibration checks to be carried out of the thermometers installed in the practice's refrigerator.

• Develop an adult safeguarding policy.

• Carry out a risk assessment to determine how often electrical equipment used at the practice should be checked for safety.

• The practice’s designated infection control lead should complete more advanced training to enable them to carry out this role more effectively.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice