What is the Quality of Facilities at Rangeways Road Surgery

Neutral

"We spoke with three members of the PPG including the PPG chair during our inspection."

Positive

"It had a palliative care register."

Positive

"The nurse advised us that the process would be improved to ensure responsibility was delegated to other staff members on the days when the nurse was not working."

Positive

"• The practice nurse was the infection control clinical lead who liaised with the local infection prevention team to keep up to date with best practice."

Positive

"The practice nurse operated an effective failsafe system for ensuring that test results had been received for every sample sent by the practice."

Positive

"Fridge temperatures were recorded by the practice nurse but no contingency had been put in place in their absence."

Positive

"• The practice nurse administered vaccines using patient group directions PGDs that had been produced in line with legal requirements and national guidance."

Positive

"The management team explained that if they were to be unsuccessful in recruiting an additional salaried GP they would consider recruiting either a physician’s associate or an advanced nurse practitioner."

Neutral

"The practice nurse also specialised in managing diabetes and often referred patients for insulin initiation."

Neutral

"We noticed how a member of staff from each team was included in the practice presentation at the beginning of the inspection; the presentation was delivered in sections by two GPs a practice nurse the healthcare assistant and the practice manager."

Positive

"The GP partners and the practice manager form the practice management team and they are supported by a senior receptionist two receptionists a practice secretary and an administrator."

Neutral

"The healthcare assistant also worked as a receptionist prior to completing their healthcare assistant training."

Positive

"Management monitoring and improving outcomes for people The practice participated in the Quality and Outcomes Framework QOF."

Positive

"One the GPs specialised in diabetes care this included teaching patients how to safely inject insulin and closely monitoring these patients with repeat visits and phone calls."

Positive

"• Reviewed information from CQC intelligent monitoring systems."

Positive

"There was a system in place for the prescribing of high risk medicines such as warfarin which required regular blood monitoring in accordance with national guidance."

Positive

"• There were procedures in place for monitoring and managing risks to patients’ and staff safety."

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

"• Arrangements were in place for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs."

Positive

"The practice had made use of the gold standards framework for end of life care GSF."

Positive

"This included ongoing support during training sessions onetoone meetings appraisals coaching and mentoring clinical supervision and facilitation and support for the revalidation of doctors."

Positive

"There was a health and safety policy in place and the practice had risk assessments in place to monitor safety of the premises including fire risk control of substances hazardous to health and legionella."

Neutral

"• The practice had an induction programme for newly appointed nonclinical members of staff that covered such topics as safeguarding infection prevention and control fire safety health and safety and confidentiality."

Neutral

"• The practice had an induction programme for newly appointed nonclinical members of staff that covered such topics as safeguarding infection prevention and control fire safety health and safety and confidentiality."

Positive

"These included a colour coded mop system to prevent cross contamination when cleaning different areas of the practice."

Positive

"While we observed the premises to be visibly clean and tidy we found that the practice did not routinely keep records to evidence that the required cleaning of specific medical equipment had taken place."

Positive

"• While we observed the premises to be visibly clean and tidy the practice did not keep records to evidence that cleaning of medical equipment such as the equipment used for ear irrigation had taken place."

Positive

"While we observed the premises to be visibly clean and tidy the practice did not keep records to evidence that cleaning of medical equipment such as the equipment used for ear irrigation had taken place."

Neutral

"Staff we spoke with assured us that cleaning records had been adapted as a priority and that these would include cleaning of medical equipment."

Neutral

"• We saw a weekly cleaning schedule to record required and completed cleaning specifications within the practice."

Neutral

"Staff we spoke with assured us that cleaning schedules would be adapted to include cleaning of medical equipment as a priority."

Neutral

"The practice offered a home visit phlebotomy service for patients who were elderly and for patients with mobility difficulties."

Neutral

"• The practice did not offer an inhouse phlebotomy service however they did offer a home visit phlebotomy service for patients who were elderly and for patients with mobility difficulties."

Positive

"• Regular medicine audits were carried out with support from the practice based pharmacist to ensure the practice was prescribing in line with best practice guidelines for safe prescribing."

Positive

"The pharmacist assisted the practice with medicine audits and monitored their use of antibiotics to ensure they were not overprescribing."

Positive

"Exception reporting is used to ensure that practices are not penalised where for example patients do not attend for review or where a medicine cannot be prescribed due to a contraindication or sideeffect."