We carried out an announced comprehensive inspection at The Junction Surgery on 27 June 2019 as part of our inspection programme.
Our judgement on the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.
We have rated this practice as good overall, with the key question of safe rated as requires improvement. The practice (under a previous registration with CQC) was previously inspected by the Care Quality Commission in July 2016 and rated as good overall.
We rated the practice as requires improvement for providing safe services because:
- The provider could not demonstrate a process for monitoring patients’ health in relation to the use of medicines including high risk medicines (for example, methotrexate) with appropriate monitoring and clinical review prior to prescribing.
- The provider could not demonstrate a process for the safe handling of requests for repeat medicines and evidence of structured medicines reviews for patients on repeat medicines.
- The provider could not demonstrate a process for reviewing people on the safeguarding register.
- We noted a back entrance door had a large crack in the full length glass pane panel. The door was also located directly opposite the bottom of a flight of stairs. This presented an ongoing risk to the health and safety of staff who used this door on a daily basis.
We found that:
- There were systems in place for reporting, recording and learning from significant incidents. Staff told us they felt supported and enabled to raise issues without fear of retribution.
- Feedback from patients was positive in relation to access to appointments and access to a clinician of choice.
- The practice was a training practice.
- Staff described a supportive and open leadership structure. A range of meetings were held which included staff at all levels.
- Quality improvement activity demonstrated improved patient outcomes.
- The practice had developed an effective relationship with a care home. The care home told us that A&E attendance by its residents had decreased as a result of the care and treatment the practice provided. The practice also promoted care home patient wellbeing through consultations to ensure patient needs were addressed.
Whilst we found no breaches of regulations, the provider should:
- Improve the recall and identification of medication review dates for patients by adhering to the practices ‘Repeat Prescribing Protocol’.
- Improve the identification and action of pathology results in a timely manner.
- Improve the process for reviewing people on the safeguarding register.
- Review and improve the information provided to patients when responding to their complaints.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.