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Reports


Review carried out on 25 March 2020

During an annual regulatory review

We reviewed the information available to us about Roysia Surgery on 25 March 2020. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 5 December 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 5 May 2016. We set a requirement in relation to Safe Care and Treatment. The practice sent in an action plan informing us about what they would do to meet legal requirements in relation to the following;

  • Robust processes were not in place to assess the risk of and prevent, detect and control the spread of infection. The practice did not have a robust legionella risk assessment and did not ensure infection control audits were completed.
  • Dispensary staff did not have training appropriate to their role and had not received annual competency assessments.

During the initial inspection we also found areas where improvements should be made:

  • The practice should record on their clinical system children who fail to attend hospital appointments by using the appropriate coding.
  • Ensure thermometers used to record refrigerator temperatures are validated and calibrated annually to ensure their accuracy.
  • Ensure all standard operating procedures are finalised and implemented.

The practice told us these issues would be addressed by December 2016 and have provided us with evidence to show they had taken the action to address these concerns.

We undertook a desk top review on 5 December 2016 to make a judgement about whether their actions had addressed the requirements.

The overall rating for the practice is good. You can read our previous report by selecting the ‘all reports' link for on our website at www.cqc.org.uk

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 5 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Roysia Surgery on 5 May 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting significant events.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Urgent appointments with a GP were available on the same day.
  • Information about services and how to complain was available and easy to understand.
  • 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 proactively sought feedback from staff and patients, which it acted on.
  • The practice was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider must make improvements are;

  • Ensure regular infection control audits are undertaken.
  • Ensure the practice has a documented Legionella policy and risk assessment.
  • Ensure that staff have received specific training appropriate to their role in the dispensary and that a formal assessment of their competence to work in this area is carried out annually.

The areas where the provider should make improvements are;

  • The practice should record on their clinical system children who fail to attend hospital appointments by using the appropriate coding.
  • Ensure thermometers used to record refrigerator temperatures are validated and calibrated annually to ensure their accuracy.
  • Ensure all standard operating procedures are finalised and implemented.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice