CQC Themes: JAN 2023

Following our Jan 23 liaison meeting with CQC, they have highlighted the following themes:

The remote GP SpA searches continue to identify some issues. This mostly relates to the monitoring of high-risk medicines, the frequency and quality of medicines reviews, long-term condition management (for example, asthma), and the diagnosis of diabetes. Also, providers should be aware that from January 2023, additional searches are now included as part of the remote inspections https://www.ardens.org.uk/cqc/ 

DNACPR documentation is often incomplete – for example, review dates are often not considered when this might be appropriate; the section on mental capacity is not always completed as required for appropriate patients; the signature is not always completed; liaison with others to inform a best interest decision is not always apparent.

Staff vaccinations continue to be an area where providers have limited or incomplete evidence. As this is now a long-standing issue, there is an expectation that providers can evidence that staff have the immunisation status required for their individual role, and there is a process to collate this asap for new starters.

MHRA alerts also continue to raise issues. Providers must be able to show evidence of what has been done in relation to appropriate alerts – this may be in the form of a log, or discussions at clinical meetings (minuted) for example. This must also be a focus on historic alerts to make sure these are periodically reviewed to ensure ongoing patient safety.

Providers who are tenants in premises owned by a landlord must still be able to show evidence that they are aware of any risk assessments relating to health and safety including fire and Legionella, and that they liaise with the landlord to be reassured that actions are being progressed and completed. There should also be a process to facilitate discussions on any ongoing site issues that arise.

Staff training – modules often found to be out of date or not completed. Practices should be clear on what they determine to be mandatory training and the frequency of updates. Leads should have done training to support their role, for example, IPCT. There is often still practices who are not receiving the correct safeguarding training relevant to their role in line with the intercollegiate guidance.

Safeguarding issues are starting to pop up regarding alerts on records of patients – less often with the safeguarding patients themselves but any family members or people who live in the same house who may be vulnerable.