Despite being rated ‘good’ for providing responsive services, a dispensing practice has been rated inadequate overall by the Care Quality Commission. As a result, the practice has been put into special measures with an inspection due in six months’ time.
Buckland Medical Practice in Dover, Kent, has 4,000 patients served by two surgeries, with a dispensary at the Tara site in St Margaret’s Bay. The practice’s handling of medicines was among the aspects rated as inadequate, under the assessment of ‘Are services safe?’.
The CQC inspection said the practice did not have reliable systems for appropriate and safe handling of medicines. Among the concerns raised were:
- the practice could not demonstrate that the cold chain was maintained when medicines were transferred to other locations;
- oxygen cylinders were not always stored safely;
- while patient’s health was monitored in relation to the use of medicines and followed up appropriately with regular patient reviews, “not all high-risk medicines had been adequately reviewed”;
- dispensary standard operating procedures were not always implemented effectively or audited for compliance;
- prescriptions at the Tara were not tracked through the practice;
- controlled drugs were not monitored appropriately;
- not all medicines were dispensed in the correct manner;
- there was not always enough information for dispensing staff, such as what medicines were suitable for inclusion in MDS;
- while action had been taken with most MHRA drug alerts, CQC inspectors found no evidence that any action had been taken with regards two alerts in the spring of 2018.
Practice staff were found to prescribe, administer and supply medicines to patients and give advice on medicines in line with current national guidance. “The practice had reviewed its antibiotic prescribing and acted to support good antimicrobial stewardship in line with local and national guidance,” said the CQC.
It also found that the practice’s complaint policy and procedures were in line with recognised guidance, but it was not always clear when complaints should be treated as near misses or significant events.
An example given by the CQC involved a dispensing error reported by a patient. “Although action had been taken to rectify the situation and conduct a risk assessment, this was not reported as a near miss to help the practice identify trends. Nor had the practice put in place any audit activity after the risk assessment,” said the CQC.
Among the actions the CQC has told the practice to take are for the registered person to demonstrate there is an effective system for managing medicines across the practice and dispensary.
Buckland Medical Practice had received ‘good’ ratings for all aspects in its 2015 inspection.