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The checks that might catch you out during a CQC inspection

An Oxfordshire practice manager, whose practice was inspected during the pilot phase of the new regime, highlights issues that might be overlooked.

CQC inspectors required evidence of an audit of staff handwashing techniques
CQC inspectors required evidence of an audit of staff handwashing techniques

The five key questions the CQC asks practices when it monitors, inspects and regulates them are: are they safe; effective; caring; responsive; and well-led?

While there is plenty of guidance available about CQC inspection and general areas of focus, first-hand accounts, providing details of the specifics being scrutinised, can highlight issues you may otherwise overlook.

If you are expecting an imminent compliance visit under the new regime, the following checklist, from the perspective of an Oxfordshire practice manager, based on their experience of inspection, pinpoints specific areas to double-check prior to your visit.

Anecdotal reports from practices visited during the pilot phase suggest inspections have been challenging, even for those with robust management and high standards of patient care so forward-planning has never been so vital.

CQC inspection checklist - issues that might catch you out:

Safe and appropriate care and treatment

  • Ensure your patient group directions (PGDs) are up to date, including those for whooping cough immunisation.
  • Define protocols for minor surgery, including consent forms.
  • Define protocols on use of chaperones and provide staff training on this.
  • Ensure receptionists are trained to handle specimens handed in to them by patients.
  • Ensure all staff wear name badges and that those who do not wear uniform launder their clothes effectively.

Medicines management

  • Show how you undertake vaccine stock control.
  • Ensure your medicines cupboard is checked for out-of-date stock on a regular basis.
  • Ensure controlled drugs are in-date and checked monthly.
  • Make sure doctors’ bags and emergency drug supplies are in-date.

Infection control

  • Undertake a comprehensive audit of infection control processes (the audit I did was not considered comprehensive, even though I downloaded it from the recommended website); it should include decontamination policy; aseptic technique; and staff infection exposure protocols, among other things.
  • Ensure you can provide ongoing evidence of infection prevention and control training being undertaken every two years.
  • Provide evidence off an audit of all staff hand-washing techniques.
  • Ensure you have a list of immunisations for staff e.g. Hepatitis B.

Cleanliness

  • Double-check the general, overall cleanliness of the clinical areas and check all furniture for debris/spillages; all chairs should have surfaces that can be wiped down.
  • Ensure all children’s toys in the surgery are thoroughly cleaned.

Safety and suitability of premises and equipment

  • Ascertain who signs for the prescription pads on delivery and how you know if any have gone missing.
  • Check and document crash equipment on a monthly basis.
  • Show you carry out cold-chain audit and have fridge-failure protocols.
  • Move all sharps bins away from ledges and ensure they are labelled with the practice name and code.
  • Lock clinical waste bins and label sharp bins (my inspector looked in the bins as well as behind the radiators and skirting boards.)
  • Check disposable instruments and ensure you can identify which need to be sent away for sterilisation.
  • Check spillage kits and display blood spillage posters.

Staffing issues

  • Ensure all staff have a folder recording their training over the past 12 months, as part of the appraisal process.
  • Ensure effective clinical supervision is in place.

Receiving and acting upon complaints

  • Know your whistle-blowing policy.

Safeguarding

  • Know your safeguarding and Caldicott representatives.

 

  • This checklist was compiled by a practice manager in Oxfordshire and provided by Berkshire, Buckinghamshire and Oxfordshire LMCs.

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