Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection of Dr Barretto & Partners, Thornton Heath Health Centre on 7 December 2016. The overall rating for the practice was good with requires improvement in Safe. Breaches of legal requirements were found relating to the Safe domain. The provider did not ensure that sufficient numbers of suitably qualified, competent, skilled and experienced persons were deployed: For example, not all staff had received appropriate training including fire safety, infection control and information governance. Also the provider did not have processes in place to ensure references were followed up.
After the comprehensive inspection, the practice submitted an action plan, outlining what they would do to meet the legal requirements in relation to the breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The full comprehensive report can be found by selecting the ‘all reports’ link for Dr Barretto & Partners, Thornton Heath Health Centre on our website at www.cqc.org.uk.
This inspection was a document-based review carried out on 8 September 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 in our previous inspection on 7 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.
The practice is now rated as Good for providing Safe services, and overall the practice remains rated as Good
Our key findings were as follows:
-
The practice had reviewed its policy on obtaining references for new staff. We saw a revised policy, a reference and a completed induction checklist, as one new member of staff had been recruited since the last inspection.
-
The practice had reviewed its policy on training; we saw a copy.
-
All staff had completed role appropriate training including fire safety training, infection control and information governance; we saw certificates for all staff members to demonstrate this.
-
Comprehensive meeting minutes were taken, detailing mandatory training including basic life support, safeguarding, information governance, infection control and when staff should have this training completed by.
-
An updated business plan had been drafted which had been reviewed in March 2017, which included all staff contact details: we saw a copy of this.
-
The practice had discussed their mission statement with all staff; we saw an agenda and meeting minutes of this discussion.
-
We saw copies of the updated complaints policy and complaints leaflet.
-
An updated recruitment selection and interview policy had been had been reviewed in January 2017, we saw a copy of this.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice