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Archived: Dr Andrew Whitfield Good Also known as Southwood Practice

Reports


Inspection carried out on 26 October 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Andrew Whitfield (also known as Southwood medical practice) on 4 October 2016, The practice was rated requires improvement overall with an inadequate rating for providing safe services. Areas where the provider needed to make improvements included reviewing the processes for implementing infection control policies, maintaining a good overview of systems and processes to mitigate risk including prescription stationary security and processes around staff administration of vaccines. Additionally, the reviewing and monitoring systems to identify staff training and to review policies and procedures.

We conducted a further comprehensive inspection on 26 October 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 at our previous inspection on 4 October 2016. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

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

  • Improvements had been made to the monitoring of infection control processes. This included undertaking further infection control audits and reviewing systems to incorporate and monitor actions required.

  • The practice had reviewed strategies for storing and checking of patient group directions (PGDs) and patient specific directions (PSDs). All PGDs were in date and signed by staff authorised to administer vaccines. PSDs were in place for the health care assistant to administer vaccines.

  • The practice had purchased locks for the printers to maintain prescription stationary security and had a process for monitoring these. Security of medicine storage had also been improved with items kept within in locked rooms or in tamper evident sealed boxes.

  • The system for monitoring staff training had been overhauled to ensure it was kept up to date and reflected what training each staff member had completed.

  • All policies within the practice had undergone a review since the last inspection. Each policy had a date for the next review identified on the policy.

  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • 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 found it easy to get an appointment on the same day and there was continuity of care.
  • There was a clear 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

There were some areas where the provider continued to need to make improvements:

The provider should:

  • Consider strategies for recording that cleaning of specialist equipment such as couches and blood pressure cuffs have been completed.

  • Review health care waste disposal in line with best practice

  • Continue to review arrangements to identify and support patients who are also carers.

  • Review GP survey results including access to arranging appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 4 October 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Andrew Whitfield in October 2016. Overall the practice is rated as requires improvement.

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

  • Not all staff were up to date with the training they needed to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Not all governance structures, systems and processes were effective and enabled the provider to identify, assess and mitigate risks to patients, staff and others.
  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • Patient comments highlighted that they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  •  Most 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.
  • The practice was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The practice had a number of policies and procedures to govern activity, but some were overdue a review.
  • The provider was aware of and complied with the requirements of the duty of candour.

Importantly, the provider must:

  • Establish and operate effective audit and governance systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients. For example to monitor safety alert guidelines to ensure they are followed through risk assessments, audits or random sample checks of patient records.
  • Ensure all medicines are held securely and  that all Patient Group Directions and Patient Specific Directions are in place for the safe administration of vaccines. Ensure an appropriate system is in place for the safe monitoring of blank prescriptions.
  • Ensure an infection control policy is up to date and that audits are effective and have a clear action plan to make improvements. To include cleaning schedules and hand hygiene audits.
  • Ensure all staff have the relevant training updates that is recorded, to ensure they have the required skills and knowledge to deliver effective care and treatment. Including, safeguarding children level two and three according to job role, health and safety, fire safety and basic life support.
  • The practice must ensure that where a person lacks capacity to make an informed decision or given consent, staff must act in accordance with the requirements of the Mental Capacity Act 2005 and associated code of practice.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Inspection carried out on 24 May 2013

During a routine inspection

We spoke with five patients�, six members of staff of different seniority, the provider and practice manager. Patients� were positive about their experiences of the service they received from all the staff at Southwood Medical Practice. Patients�� said �they could not fault the GP�. They stated they always felt the �staff respected them as individuals�.

Patients� who used the service were treated with respect and involved in making decisions about their care and treatment. They experienced care and treatment that met their needs and was centred on them as individuals. The provider took proper steps to ensure that patients�� were protected against the risks of receiving care or treatment that was inappropriate or unsafe.

Patients�� who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. They were cared for in a clean and hygienic environment. The patients�� were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider had an effective system to regularly assess and monitor the quality of service that patients� received.