The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Richard Lynch-Blosse Also known as Clifton Hampden Surgery

Overall: Good read more about inspection ratings

Watery Lane, Clifton Hampden, Abingdon, Oxfordshire, OX14 3EL (01865) 407888

Provided and run by:
Dr Richard Lynch-Blosse

All Inspections

We have not revisited Dr Richard Lynch-Blosse as part of this review because they were able to demonstrate that they were meeting the standards without the need for a visit.

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Richard Lynch-Blosse on 8 December 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the December 2016 inspection can be found by selecting the ‘all reports’ link for Dr Richard Lynch-Blosse on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 17 July 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 in our previous inspection on 8 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

We found the practice had made improvements since our last inspection. The desk based review on the 17 July 2017 found the practice was meeting the regulations that had previously been breached.

We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe and well led services. Overall the practice is now rated as good. Consequently we have rated all the population groups as good.

Our key findings were as follows:

  • Dispensing procedures had been updated to ensure compliance with national guidance. All prescriptions were authorised and signed by a GP before medicines were dispensed to patients.
  • Controlled drugs were stored, recorded and destroyed in accordance with national guidance.
  • Security arrangements for clinical waste awaiting collection were appropriate.
  • Health checks for patients diagnosed with a learning disability were either completed or scheduled.
  • Appropriate safety checks to the premises had been completed and actions arising from risk assessments had been carried out.
  • The processes for carrying out medicines reviews had been reviewed and the number of medicine reviews completed had increased. Data showed 76% of all medicine reviews had been completed with 94% of patients taking four or more medicines receiving a review in the last year.
  • Responses to complaints and the practice complaints policy contained reference to the opportunity for escalation of the complaint to a relevant statutory body.
  • The system for receipt of, and recording action arising from, safety alerts had been updated and identified when actions had been completed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

8 December 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Richard Lynch Blosse (also known as Clifton Hampden Surgery) on 8 December 2016. Overall the practice is rated as requires improvement. Specifically the practice is rated good for provision of effective, caring and responsive and well led services. However, we found areas where the practice needed to make improvements in the provision of safe and well led services.

  • 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. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Developments in delivery of care for patients with long term conditions were targeted and outcomes for this group of patients had improved during recent years.
  • Patient feedback was consistently positive about accessing the service and receiving compassionate care from a dedicated and professional practice team. Patients were also positive about being 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.
  • Patients said they found it easy to make an appointment with their usual GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice was active in developing and expanding services. For example, expanding the range of minor surgery available and extending the times that patients could book for blood tests.
  • 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 and complied with the requirements of the duty of candour.
  • Some aspects of medicines management were inconsistent. For example, repeat prescriptions were not signed by GPs before they were dispensed. Near misses within the dispensary were recorded but the learning from them was not shared with the team.
  • There were processes in place to identify, assess and manage risk but these had failed to identify some risks. For example, outcomes of action from national safety alerts were not recorded, a fixed wiring test had not been completed in the last five years and medicine reviews were not recorded appropriately.
  • The practice identified patients with a learning disability but had not made arrangements for this group of patients to receive an annual health check in the last year.

We saw some areas of outstanding practice:

  • The practice achieved a take up rate for cervical cytology screening of 94% which was significantly better than the

  • The local health visitors were based at the practice enabling daily contact with the practice GPs and nurses. This assisted prompt discussions about thecare of young children and any at risk children and facilitated effective co-ordination of care for this group. It also enabled prompt identification of any safeguarding issues.

  • If a child or young person needed an appointment after school hours on the afternoons when booked clinics were not held the GPs offered an appointment at a time to suit the young patient and their family before the practice closed.

The areas where the provider must make improvement are:

  • Ensure repeat prescriptions are signed by an authorised prescriber before patients collect their medicines from the dispensary.

  • Ensure learning from incidents and near misses in the dispensary is shared with relevant staff.

  • Ensure a fixed wiring test is undertaken in accordance with electrical safety regulations.

  • Ensure control measures required from the legionella risk assessment are undertaken consistently.

  • Ensure a system is in place to assure the practice that all actions arising from national safety alerts have been completed.

The areas where the provider should make improvement are:

  • Ensure arrangements are in place to deliver annual health checks for patients diagnosed with a learning disability.

  • Ensure records of medicine reviews for patients are consistently recorded in the patient’s medical records in accordance with the practice protocol.

  • Ensure the clinical waste bin is secured to a permanent structure.

  • Provide assistance to patients who use hearing aids by installation of a hearing loop.

  • Review the categorisation of controlled drugs to ensure only those requiring witnessing of destruction are recorded in the destruction register.

  • Include reference to the availability of second stage arbitration by either the parliamentary and health services ombudsman or NHS England in replies to patient complaints.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice