What is the Quality of Facilities at Richmond Surgery

Positive

"The GPs are supported by a specialist nurse and three practice nurses a health care assistant and a phlebotomist phlebotomists are medical technicians who are trained to take blood samples from patients."

Positive

"The GPs are supported by a specialist nurse and two practice nurses a health care assistant and a phlebotomist phlebotomists are medical technicians who are trained to take blood samples from patients."

Positive

"A GP and senior nurse had received training on how to care for people with dementia."

Positive

"Appointments both in advance and on the day were also available weekday mornings excluding Wednesday for the senior nurse s minor illness clinic."

Positive

"Feedback from a previous survey indicated that patients were unhappy with nurse waiting times."

Neutral

"Telephone consultations were also available with the GP or senior nurse for patients who could not attend the practice."

Neutral

"The lead nurse was the lead for infection control."

Neutral

"We were told by the practice manager that they knew what to look for on recruitment and went on to describe the checks they would undertake for a nurse and an administrator."

Neutral

"There was a lead nurse for infection control and the senior partner was the lead for safeguarding."

Neutral

"As a result the practice employed another practice nurse to address this."

Positive

"We based our judgement of the quality of care at this service 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."

Positive

"• We found some governance and risk monitoring processes that required a review."

Positive

"Specifically patient specific direction processes patient group direction authorisation and monitoring and oversight of the cold chain."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Neutral

"• There was no monitoring of cold chain documentation to ensure it was being maintained in line with guidance."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Positive

"Management monitoring and improving outcomes for people Staff from across the practice had key roles in the monitoring and improvement of outcomes for patients."

Positive

"There were clinical monitoring systems in place and the practice improved as a result."

Positive

"Learning and improvement from safety incidents The practice had a system in place for reporting recording and monitoring significant events incidents and accidents."

Neutral

"It is based on a combination of what we found when we inspected information from our ongoing monitoring of data about services and information given to us from the provider patients the public and other organisations."

Neutral

"Staff told us about the arrangements for planning and monitoring the number and skill mix of staff needed to meet patients’ needs."

Positive

"Medicines Management We checked medicines that were stored in treatment rooms and medicine refrigerators and we found that the rooms were secure."

Neutral

"Patients had a named GP and structured annual reviews to check that their health and medicine needs were being met."

Positive

"However where health and safety risks were identified and action plans produced these were not implemented or monitored."

Neutral

"Newly appointed staff carried out induction training which included equality and diversity health and safety fire safety and information governance."

Positive

"Fabric curtains were used in treatment and consulting rooms but there was no schedule of planned cleaning or changing of these curtains to minimise the risk of cross infection."

Positive

"Action the service SHOULD take to improve • Improve infection control with repair or replacement of the floor covering in one of the treatment rooms and devise a cleaning programme for the material curtains around examination couches."

Positive

"Also material curtains were used in the treatment and consulting rooms but a cleaning programme was not in place to identify the type and frequency of cleaning required to minimise the risk of cross infection."

Neutral

"Cleaning schedules in place for the cleaners and cleaning records were kept."

Positive

"The practice provided a personal service for patients who received palliative care."

Positive

"This room was small and not accessible to a wheelchair user without furniture being removed first."

Positive

"However we found that the building was not fully accessible to wheelchair users."

Positive

"For example the reception desk was high and out of reach of a wheelchair user."

Positive

"A patient toilet was available but staff confirmed this was not accessible for a wheelchair user due to its small size."

Positive

"The practice was awarded the Gold Standard Framework and records of meetings for end of life care showed involvement of district nurses health visitors and McMillan hospice nurses."

Positive

"There were delegated responsibilities to named GPs such as a lead for the safeguarding of vulnerable adults and children a prescribing and a clinical governance lead."

Neutral

"The practice had a system in place for completing clinical audit cycles."