Archived: The Malago Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Malago Surgery on 24 February 2016. The overall rating for the practice was requires improvement for the safe, effective, responsive and well-led domains. The practice were rated as good for caring services. The key areas of concerns found during that inspection were:

• the practice did not have effective systems for infection control, had not identified a member of staff as an infection control lead and had not shown that appropriate actions were taken to address areas of concern promptly.

• the practice did not have suitable arrangements in the practice for managing medicines, including emergency medicines, vaccinations, and prescription stationary to keep patients safe.

• the practice did not have effective systems in place which promoted the health and safety of staff and patients at the practice.

• the practice did not evidence that appropriate checks had been made and did not have the required information in regard to the locum GPs who worked at the practice.

The full comprehensive report on the February 2016 inspection can be found by selecting the ‘all reports’ link for The Malago Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection which we carried out on 13 February 2017. Its purpose was to confirm that the practice had carried out their action plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 24 February 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

• the provider now had effective systems for infection control and had identified a member of staff as an infection control lead and had shown that appropriate actions were taken to address areas of concern promptly.

• the provider now had suitable arrangements in the practice for managing medicines, including emergency medicines and vaccinations, and prescription forms to keep patients safe.

• the provider now had effective systems in place which promoted the health and safety of staff and patients at the practice.

• the provider evidenced that appropriate checks were made and had appropriate information held in regard to the locum GPs who worked at the practice.

• the provider had ensured that staff had the skills, knowledge and experience to deliver safe and effective care and treatment.

• the provider had implemented a safe system in place for managing complaints that ensured that they were investigated and acted upon sufficiently. Any learning from complaints was shared with staff and other stakeholders. Feedback from patients, such as comments left on NHS Choices, were responded to and acted upon

• the provider had a documented business plan to support the development of the service.

• there were designated leads in the staff team to manage key areas of the service provision.

• practice policies had been reviewed or updated in a timely way

• there were now management and governance systems for the provider to ensure there were safe systems in place for health and safety, infection control, medicines management, safe recruitment, staff training and the management of complaints.

However, there were also areas of practice where the provider needs to continue to make improvements.

In addition the provider should:

• ensure that the changes made to the protocols for the management of prescription stationary in accordance with NHS England’s prescription paper management are sustained.

• ensure the protocols in regard to appropriate temperature safety checks for medicines refrigerator checks are sustained.

• ensure that the changes in the recruitment and management of any future GP locums employed are sustained.

• ensure that there is a sustained regular fire drill and alarm check programme.

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 comprehensive inspection at The Malago Surgery on 24 February 2016. Overall the practice is rated as requires improvement. The domains for safe, effective, responsive and well led are rated as require improvement. Caring was good.

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

• There was a variable approach to managing safety at the practice although they had an effective system in place for reporting and recording significant events.
• Risks to patients, staff were not always assessed and well managed.
• 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.
• The practice took steps to address shortfalls in clinical staffing and made alternative arrangements to ensure patients continued to receive the care and treatment they needed.
• Patients said 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. However, the complaints handling process within the practice was not robust.
• Patients said they were able to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and had the equipment to treat patients and meet their needs.
• There was a leadership structure and staff felt supported by management. The practice sought feedback from staff and patients.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider must make improvement are:

• The practice must ensure it has effective systems for infection control, a lead is appointed and that appropriate actions are taken to address areas of concern promptly.

• The practice must ensure it has suitable arrangements in the practice for managing medicines, including emergency drugs and vaccinations, and prescription forms to keep patients safe.

• The practice must ensure there are effective systems in place which promote the health and safety of staff and patients at the practice.

• The practice must ensure appropriate checks are made and information held in regard to the locum GPs who had worked at the practice.

• The practice must ensure it has an appropriate system in place for managing complaints, to include being investigated sufficiently and learning from complaints being actioned and shared with staff and other stakeholders

• The practice must ensure that staff receive appropriate health and safety training.

The areas where the provider should make improvement are:

• The practice should maintain adequate records in regard to staff training.

• The practice should ensure that a lead staff member is trained and identified to ensure safe management systems are in place for infection control.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice