Archived: Hobmoor Road Surgery

Letter from the Chief Inspector of General Practice

On 21 January 2016 we carried out a comprehensive inspection at Hobmoor Road Surgery. The practice was rated as good overall, but requires improvement under the safe domain. As a result of that inspection we found that improvements were required so we issued the practice with a requirement notice for improvement.

We then conducted a focused inspection of the practice on 8 April 2016 to check whether the improvements had been made. At this inspection we found that the improvements identified at the January inspection had been actioned. However we found some new concerns.

The concerns related to recruitment processes and staff who acted as chaperones who had not received a Disclosure and Barring Service check (DBS check) nor in its absence had a risk assessment been carried out to make sure patients were protected. As a result the practice was issued with two new requirement notices for breaches of regulation 17 (Good governance) and regulation 19 (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This meant that the practice continued to be rated as requires improvement for the safe domain.

We also found a number of areas where the practice should make improvements that were not specific breaches of the regulations. These included infection control processes and ensuring that the safeguarding policy was updated to reflect current practice and disseminated to all staff.

We then carried out a focused inspection at the practice on 1 September 2016 to review the action taken by the provider to meet the regulatory requirements where we had identified breaches of the regulations and other areas where they should take action. The report should therefore be read in conjunction with both the full comprehensive inspection report published on 21 January 2016 and the subsequent focussed report published on 19 May 2016.

At this inspection we found the practice had made changes since their previous focused inspection. We found that sufficient action had been taken regarding the issues identified and the practice was now meeting the requirements of the breaches identified. This meant that the practice was now rated as good in safe domain. All other domains were previously rated as good.

Specifically we found that since the last inspection:

• The practice had ensured the recruitment policy was being properly implemented to ensure that all necessary employment checks were taking place for all staff.
• All staff, including those who acted as chaperones had now undergone the appropriate checks through the DBS.
• The practice had reviewed and updated the safeguarding policy and disseminated to all staff. Post-inspection, one of the GPs completed safeguarding training to an appropriate level and provided us with evidence of this.
• Previously we found that practice processes for completing and monitoring required infection control and prevention actions were not in place. At this inspection the practice told us the actions had been completed and post-inspection we were provided with evidence to demonstrate this.

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 focused inspection at Hobmoor Road Surgery on 08 April 2016.

During our previous inspection of the practice on 11 August 2015 we had identified concerns relating to the unavailability of oxygen in case of an emergency. In the absence of this, the practice had not completed a risk assessment to demonstrate how it would manage an emergency which might require the use of oxygen. The practice was issued with a requirement notice for a breach under Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment. The practice was previously rated Good overall, but Requires Improvement for providing safe services.

This inspection was to review the action taken by the provider to meet regulatory requirements where we had previously identified a breach by re-inspecting the Safe domain. For this reason we focused the inspection on the Safe domain. The report should be read in conjunction with the full inspection report published in January 2016.

At this inspection we found the practice had made a change since their previous inspection in August 2015 and was now meeting the requirements of the breach identified at the previous inspection. However, we also found new breaches under different regulations (Regulation 17 HSCA (RA) Regulations 2014 Good governance and under Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed). This meant that the practice was still rated as requires improvement for the Safe domain.

Specifically we found:

• Arrangements were in place to help keep patients at safe in relation to medicine management and in an emergency. Since the last inspection, the practice now had oxygen available although only an adult mask was available.

In addition the practice continued to demonstrate good practice in the following areas:

• There was an effective system in place for reporting and recording significant events.
• Risks in relation to the premises, including fire safety were being appropriately managed.

The areas where the provider must make improvements are:

• Ensure recruitment arrangements include all necessary employment checks for all staff.
• Ensure risks are assessed for all staff acting as chaperones.

In addition the provider should:

• Review the practice processes for completing and monitoring required infection control and prevention actions.
• Review and update procedures and guidance including the safeguarding policy, to ensure any new arrangements are fully reflected and that all staff are aware of these.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice