November 2018 update
In May 2018 a follow up visit was made by CQC and the practice ratings were set to 'good'.
Due to the ongoing publication of the old CQC reports on their website we have to publish our reservations about the previous inspections on our website. The oxygen issue has been clarified in an article in the British Medical Journal this year, as it was twenty years ago.
August 2017 update.
Another inspection was carried out in April.
Thanks to all the patients who have contacted the CQC, have responded to the national patient survey and have reviewed the practice on the NHS website. We go by your feedback and try to provide the best service to benefit most. Minimise the administration and maximise looking after you.
This time the inspectors did not seem to carry as much prejudice as last year, however we continue to receive low ratings. Dr Beerstecher is still not clear how the ratings are devised and many practices that have a 'good' rating have much worse patient satisfaction ratings and many more listed shortcomings that seem -on face value- much more serious.
The inspection report with Dr Beerstecher's comments is on the right, and the new 'merged' file and improvement notices are here as well. A hint, if you want to see the comments, then open the 'comments' pane in Adobe.
The list with requirements after the inspection is below, the list of requirements before the visit are in the 2017 CQC presentation on youtube. It is exhausting, as the issues listed were already addressed and assessed and written up before the inspection, like cleaning records, checking equipment, how we organise the practice and some of the issues were already in the presentation like how the NHS messes up the child vaccine coding, how the information used by CQC is out of date and inappropriate. QOF scores do not represent the quality of patient care, they represent how much money the practice makes from entering codes on the computer. We do not believe in keeping lists of people with certain characteristics, we treat everyone the same and do not discriminate or give unfair advantages to some patients. Everyone should have the right to receive the same level of care.
Comments on this list are in the merged file and the report on the right.
"The areas where the provider must make improvements are;"
Ensure the health and safety law poster is displayed on the premises in line with the Health and Safety at Work etc. Act 1974. -- We issued leaflets
Revise risk management and ensure that all risks to patients, staff and visitors, including fire safety risks and risks associated with the control of substances hazardous to health, are assessed and well managed. -- we collected COSSH sheets on the toilet duck in the staff toilet and the washing up liquid in the canteen.
Revise systems to ensure the practice is able to respond to a medical emergency in line with national guidance. -- We are going to order a child mask for the oxygen with the next order for supplies.
The areas where the provider should make improvements are;
Keep records of domestic cleaning carried out as well as any cleaning audits conducted at the practice. -- We had already provided a risk assessment to the CQC,
Consider physically checking emergency equipment and emergency medicines at least on a weekly basis in line with Resuscitation Council (UK) guidance. -- See the CCG page for information on this, we know if we resuscitated someone in the surgery, it is yet to happen in 22 years of practice.
Continue to replace out of date emergency medicine as soon as replacement stocks become available -- If medication is not available, it is not available.
and consider replacing the medical oxygen cylinders with ones that carry expiry dates. -- We already had an extensive risk assessment on this last year.
Add emergency contact numbers for staff to the business continuation contingency plan. -- We already explained that they change, depending on the holiday destination, and where they are kept.
Continue to improve patient outcomes, in particular for those patients with mental health problems. -- QOF scores reflect how many codes have been added to the computer, not whether patients can get appointments if they need to be seen.
Formalise and maintain records of all staff appraisals. -- Records of appraisals have always been kept.
Improve coding activity to help ensure all childhood immunisation activities are captured in practice activity data. -- See the video on youtube, it is not our coding.
Continue to identify patients who are also carers to help ensure they are offered appropriate support. -- See the video on youtube, we offer appointments to all patients, even if they are not carers.