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Wednesday, 30 July 2014

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Safety and hygiene concerns at north Cumbrian GP practice

Shocking safety and hygiene standards at a north Cumbrian GP practice have been slammed by inspectors who have ordered urgent improvements.

Dalston GP practice photo
The practice in Dalston

On one occasion a nurse at Dalston Medical Group wrongly gave a vaccine to a patient, while another person had to wait five weeks for medicine which their hospital consultant had requested immediately.

The practice was found to be dirty, while inspectors also flagged up concerns about medicines being left in unlocked areas and not being properly accounted for.

A dirty boiler had not been checked for two years and was deemed a fire hazard, Legionella checks were not being carried out, and staff training and policies were out of date.

A team from the Care Quality Commission (CQC) visited the surgery, in Townhead Road, in May as part of a new regime of inspections at GP practices.

Their report reveals serious concerns in a number of areas and calls on leaders to make urgent improvements. However, not all of the findings were negative.

General care and treatment was up to scratch and all of the patients they spoke to were happy and praised staff.

The practice said that work is underway to tackle the issues raised. Concerns highlighted in the report include:

  • “On the day of the visit we found that one of the nurses had misadministered a vaccine.

The nurse told us they checked that the patient was not harmed. They also told us they were not aware that this type of incident needed to be reported to the management team.

  • “We found a patient had attended a hospital outpatient appointment and the consultant asked the GPs to commence a medicine immediately.

“The staff had not followed this direction and some five weeks lapsed before the patient was seen and medicine started. Again this was not deemed to be an incident.”

  • “We saw all areas of the practice were dirty. Sink areas were blackened, there was no hand washing signs, bins were not foot operated which meant risk of cross contamination was not being appropriately reduced, and antibacterial hand gel was not available.”
  • “The curtains in one room were visibly dirty and staff told us they had not been cleaned since 2012. We found that staff were not taking action to reduce infection risks.”
  • “We saw that directives for nurse practitioners, which detailed which medicines they could prescribe, were out of date. For one instance the directive for mumps, measles and rubella immunisation did not reflect that one of the vaccines being administered had been changed to a different type.”
  • "We found no evidence to confirm that staff had received safeguarding and child protection training. Staff told us that they had attended both types but not in the last two years.”
  • “In the main practice we found that medicines were stored in a haphazard manner. The medicines were not kept securely and could easily be accessed by patients and visitors.”

In a statement, the Dalston Medical Group, which has around 5,500 patients and five GPs, stressed that its doctors were found to be providing good care and treatment, meeting patients’ needs and referring them for specialist treatment when required.

It added: “Where we have not performed well is in the administrative processes that take place in the background.

“We recognise that systems and processes should have been put in place but these were not properly addressed in the past or allowed to lapse without updates and revisions.

“All this took place with the previous management team.

“We now have a new practice manager in post who is working hard to address the issues identified.

“We would like to reassure all our patients that the care they receive is second to none. It is the background administrative processes that we need to improve.”

Sue McMillan, who is the CQC’s deputy chief inspector of primary medical services in the region, said: “We were extremely disappointed to find these shortfalls and have warned Dalston Medical Group that immediate improvements must be made.

“We continue to monitor the situation carefully and we will inspect again in the near future to ensure concerns have been addressed and patients are being given the service they are entitled to expect,” said Ms McMillan.

“If we find it has not made the required improvements we will consider the need for further regulatory action as necessary.”

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