| Standard not met | Reason | Action being taken by the Pharmacy | By when | Notification By Pharmacy Improvements Made |
|---|---|---|---|---|
| 1.1 | The pharmacy provides its services at a distance, but it does not have written risk assessments for all the services it provides. So it cannot demonstrate all the risks have been considered and that it takes appropriate action to mitigate againt them to help provide services safely and effectively. |
Risk assessment to be written up and actioned by pharmacy staff. |
10/09/2025 | 11/08/2025 |
| 1.1 | The pharmacy delivers all medication to people’s addresses, as the pharmacy’s NHS contract does not permit people to collect it from the pharmacy. Sometimes, medicines are delivered to alternative locations or posted through the letterbox. But this does not match the pharmacy’s written procedures, and it cannot show it has considered the risks with this practice. So the pharmacy is unable to show this is a safe practice. |
New SOPs to be written for deliveries and staff to be trained in new SOPs. |
10/09/2025 | 11/08/2025 |
| 1.1 | The pharmacy dispenses medicines into multi-compartment compliance packs from electronic prescriptions which have been issued as a batch prescription for up to six months at a time. But the pharmacy has not considered the risks of providing this service at a distance, such as managing points of contact with vulnerable people. So the pharmacy cannot demonstrate how it checks people are taking their medicines safely. |
New risk assessment to be written. |
10/09/2025 | 11/08/2025 |
| 3.1 | The pharmacy premises are untidy. It is cluttered with stock in areas where dispensing activity takes place along with medicine tote boxes on the floor. It has loose, and disregarded tablets spread throughout the pharmacy. And some medicines are stored on the floor. This creates tripping hazards for members of the team and increases the risk of medicines becoming damaged. This may may also increase the risk of errors occurring. So the pharmacy is not able to demonstrate that its premises enables services to be provided safely and effectively. |
Pharmacy has already been tidied and new shelving put in and new sections made |
10/09/2025 | 11/08/2025 |
| 4.2 | The pharmacy routinely dispenses medicines into multi-compartment compliance packs from electronic prescriptions which are issued on the day the person is due their medicines. But if the prescription is delayed, people do not receive all of their medicines on time. And the pharmacy cannot show it has considered the safety and effectiveness of providing the service in this manner to people who are vulnerable. |
New risk assessment will cover this. |
10/09/2025 | 11/08/2025 |
| 4.3 | The pharmacy decants some of its medicines into suitably labelled containers to aid the delivery of its pharmacy services. But a number of the containers are not labelled in the correct manner. This may increase the risk of a dispensing error, or dispensing medicines which are not fit for purpose. |
All pots have already been re-labelled correctly. |
10/09/2025 | 11/08/2025 |
| 4.3 | The pharmacy has fridges for medicines which Require cold storage conditions. But the temperature of one of the fridges is not in the required range, and members of the team do not take action to rectify this issue. So the pharmacy is not able to demonstrate its fridge medicines are stored correctly to ensure they remain fit for purpose. |
New Fridge already purchased. |
10/09/2025 | 11/08/2025 |
Pharmacy inspections
Inspection reports and learning from inspections