Tettenhall Medical Practice

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Tettenhall Medical practice on 9 May 2017. The overall rating for the practice was requires improvement for providing safe and well-led services. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Tettenhall Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 20 December 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 at our previous inspection on 9 May 2017.

Care and treatment was not being provided in a safe way to patients in particular:

• Evidence that national guidelines for children who do not attend for hospital events were followed at all times was not available.
• Systems were not in place for the proper and safe management of medicines to ensure the safe management of high risk medicines; blank computer prescription forms and Patient Group Directions (PGDs).
• The minutes of meetings were not sufficiently detailed to demonstrate that any changes made following significant events were appropriate and prevented further occurrences.

Overall the practice is now rated as Good.

Our key findings were as follows:

• Effective systems had been introduced to monitor and follow up children who did not attend for hospital events.
• Employment checks had been followed up and completed for all staff employed and the required information was available in staff files.
• Staff training needs had been reviewed to ensure all staff had received up to date training related to health and safety such as fire safety and infection control.
• Systems were put in place for the proper and safe management of medicines.
• Patient Group Directions (PGDs) were updated at the time of the inspection and confirmation received that all were signed by a GP and the practice nurses.
• Formal systems were implemented for monitoring the security of blank computer prescription forms.
• The documentation of significant events in minutes of meetings had improved.

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 Tettenhall Medical Practice on 9 May 2017. Overall the practice is rated as requires improvement.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Formal arrangements were in place for recording and reporting on significant events but documented evidence was not available to show any changes made were monitored to confirm improvements are appropriate.
• 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.
• Some risks were managed, but action was needed in the areas of medicines management, staff recruitment, health and safety training.
• Staff had received some training appropriate to their roles but appraisals and development plans had not been completed for over 12 months.
• 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.
• The practice was well equipped and maintained to treat and meet patients’ needs.
• Clinical audits were carried out and demonstrated improvement.
• There was a leadership structure and staff felt supported by management.
• The practice was aware of and complied with the requirements of the duty of candour.

The areas where the practice must make improvements are:

• Ensure national guidelines for children who do not attend for hospital events are followed at all times.
• Ensure necessary employment checks are completed for all staff employed and the required information in respect of persons employed by the practice is held.
• Ensure that the practice protocols are reviewed so that all staff have up to date training related to health and safety such as fire safety and infection control.
• Ensure systems are put in place for the proper and safe management of medicines.

• Ensure that all Patient Group Directions (PGDs) are up to date and signed by a GP and the practice nurses before administering the specific medicines included in PGDs to patients.

The areas where the practice should make improvements are:

• Ensure the minutes of meetings are sufficiently detailed to show that any changes made following significant events are appropriate and prevented further occurrences.

• Introduce a formal system for monitoring the security of blank computer prescription forms.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice