| Standard not met | Reason | Action being taken by the Pharmacy | By when | Notification By Pharmacy Improvements Made |
|---|---|---|---|---|
| 1.1 | The pharmacy is not identifying and managing several risks associated with its services. The team has not read nor signed all of the pharmacy's standard operating procedures (SOPs). |
The team will have read and signed the electronic record card for each SOP relevant to their role. |
23/03/2023 | 09/05/2023 |
| 2.1 | The pharmacy does not have enough suitably qualified and skilled staff available at all times to consistently provide its services safely and effectively. The current staffing arrangements are inadequately managed to fully cope with the workload, so routine tasks are not being completed or undertaken in a timely manner. |
We have reviewed the workload and skill mix in the pharmacy and we are confident that there are sufficient hours available. We have conducted an operational review and identified areas to improve efficiency and manage the workload. |
06/04/2023 | 09/05/2023 |
| 2.5 | Members of the pharmacy team are inadequately supported, and under-resourced. There is limited evidence that sufficient action has been taken when team members have raised legitimate concerns. And they are not provided with opportunities to discuss feedback or concerns due to the lack of regular team meetings, updates from the regional team or recent performance reviews. |
Ensure all colleagues have an annual performance review. |
23/03/2023 | 09/05/2023 |
| 3.1 | Parts of the pharmacy are not adequately maintained. There are significant health and safety risks that have not been managed appropriately despite accidents occurring and staff reporting this. This includes several broken drawers used to hold medicines which routinely fall out causing injuries and a trailing extension lead which runs past a water source. Shutters used to secure medicines overnight are broken and frayed making them unfit for purpose. |
Shutters to be removed as they are not part of our current security measures. The pharmacy is alarmed. |
23/03/2023 | 09/05/2023 |
| 4.3 | The pharmacy has compromised the safety of medicines and medical devices due to inadequate |
Pharmacy to be date check and ongoing to maintain the routine. |
23/03/2023 | 09/05/2023 |
| 5.2 | Some of the CD cabinets are not secured fully in line with legal requirements. This compromises the security of these medicines. |
CD cabinet to be rag bolted. |
23/03/2023 | 09/05/2023 |
Pharmacy inspections
Inspection reports and learning from inspections