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Archived: Oundle Good Also known as Dr Stovin & Partners

Reports


Inspection carried out on 8th February 2017

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

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Oundle on 7 June 2016. The overall rating for the practice was good, with requires improvement for the safe domain. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Oundle on our website at www.cqc.org.uk.

We undertook this follow-up focused inspection to check that they had followed their plan and to confirm that they now met legal requirements in relation to the breach identified in our previous inspection on 7 June 2016. This report only covers our findings in relation to those requirements.

Overall the practice is now rated as good. However, on the inspection on 7 June 2016, there were areas of practice where the provider needed to make improvements.

We found that the provider must:

  • Ensure that staff who undertake chaperone duties have received a Disclosure and Barring Service (DBS) check or that a written risk assessment is in place.

In addition, we found that the provider should:

  • Review the infection control policy and audit tool used ensuring that it is robust and meets the standards as outlined in The Health and Social Care Act 2008: code of practice on the prevention and control of infections and related guidance.

  • Review the monitoring of the fridge temperatures ensuring that comments and actions as appropriate are taken should the temperature not be within the required range.

  • Ensure that access to the dispensary is restricted to authorised staff only.

  • Improve the record keeping of medicines stock levels in the dispensary.

  • Ensure that all electric equipment is tested or risk assessed and is safe to use.

  • Proactively identify and offer support to carers.

  • Ensure that the risk assessment for legionella testing is completed and any actions taken.

  • Improve the management oversight of significant events to ensure trends can be identified to encourage improvement.

At this inspection we found that

  • The practice had Disclosure and Barring Service (DBS) checks in place for all chaperones.

  • The infection control audit had been completed but could be improved further.

  • Staff were regularly documenting fridge temperatures and action had been taken as required.

  • The security measures for the dispensary had been reviewed and access was only given to authorised staff.

  • Stock levels and expiry dates of medicines were checked and documented monthly.

  • Electrical equipment had been tested.

  • The practice had completed a legionella risk assessment.

  • The practice had a proactive approach to the management, discussion and disseminationof significant events and had implemented a spreadsheet log.

  • The practice identified 35 carers; this was less than 1% of the practice population. The practice recognised this was low, but also recognised that they had a lower number of older patients. The practice identified carers at registration, as well as during appointments for those being cared for. The practice had been proactive in using the carer templates on the clinical system and invited carers to receive a yearly flu injection and signposted them to local groups. The practice had information in the waiting area for carers and leaflets, including information on support groups.

However, the area where the practice should make improvements are:

  • The practice should implement a system to mitigate the risks of legionella disease by monitoring the water temperature regularly.

  • The practice should further improve the management of infection control b

Therefore, practice is now rated as good in the safe domain, and good overall.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 7 June 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Oundle Medical Practice on 7 June 2016. Overall the practice is rated as good.

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

  • The appointment system was flexible and ensured that patients who requested to be seen on the same day were.

  • The practice had good facilities including for those with reduced mobility.

  • Information about services and how to complain was available. The practice sought patient views about improvements that could be made to the service, including having a patient participation group (PPG).

  • The practice proactively managed care plans for vulnerable patients and had effective management strategies for patients at the end of their life.

  • The practice had a number of policies and procedures to govern activity; however, the oversight to ensure that they were reviewed timely needed to be improved.

  • Systems to reduce risks to patient safety for example, where in place, however, the practice had not undertaken a legionella risk assessment. An infection control audit had been undertaken; this audit did not contain sufficient detail and needed to be improved.

  • There was a leadership structure, staff felt supported by the management team and were an integral art of the running of the practice.

  • Patients’ needs were assessed and care was planned and delivered following best practice guidance.

The areas where the provider must make improvements are:

  • Ensure that staff who undertake chaperone duties have received a disclosure and barring check (DBS) or that a written risk assessment is in place.

In addition the provider should;

  • Review the infection control policy and audit tool used ensuring that it is robust and meets the standards as outlined in The Health and Social Care Act 2008: code of practice on the prevention and control of infections and related guidance.

  • Review the monitoring of the fridge temperatures ensuring that comments and actions as appropriate are taken should the temperature not be within the required range.

  • Ensure that access to the dispensary is restricted to authorised staff only.

  • Improve the record keeping of medicines stock levels in the dispensary.

  • Ensure that all electric equipment is tested or risk assessed and is safe to use.

  • Proactively identify and offer support to carers.

  • Ensure that the risk assessment for legionella testing is completed and any actions taken.

  • Improve the management oversight of significant events to ensure trends can be identified to encourage improvement

We saw an area of outstanding practice;

  • Due to the geographical location of the practice, they are required to engage with more than one safeguarding and health visiting team .The practice identified over five years ago that this could sometimes delay appropriate responses. The practice holds quarterly meetings at the practice and representatives attend these meetings from all state schools in the area, the police, GPs, and nurses. Representatives from Service Six (mental health services for adults and children), and an Early Help co-ordinator attend. The practice told us that this had ensured that the multi-disciplinary team were able to identify concerns and respond in a timely way. This is a robust way to ensure that children who may be at risk and their families are kept safe and given appropriate support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 3, 6 January 2014

During a routine inspection

On the day of our inspection we spoke with six patients and with eight members of staff including a GP and the practice manager. All the patients were positive about their experiences with the service. One patient told us, “I cannot fault the care provided. It’s a really good practice.” Several told us that they had no problems getting an appointment and recent changes to the system had helped. Patients told us that reception staff were polite and helpful and that the repeat prescription service operated well.

We saw that care and treatment were planned and delivered in a way that met patient’s needs. One patient told us, “The doctors listen and pay attention to what I tell them and I feel able to discuss any problems with them”.

We saw that care was delivered in a clean environment preventing the risk of infection to patients and staff. Patients confirmed this to us.

Staff received training in safeguarding (protecting vulnerable adults and children). They were aware of the appropriate agencies to refer any concerns to. We saw evidence that staff were well trained and supported to deliver care to an appropriate standard.

There were established quality monitoring systems in place to assess and monitor the quality of service that patients received. There were methods to obtain patient feedback and an active Patient Participation Group.