This practice is rated as Good

 overall. (Previous inspection June 2015 – Overall Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Outstanding

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those retired and students – Good

People whose circumstances may make them vulnerable – Outstanding

People experiencing poor mental health (including people with dementia) – Good.

We carried out an announced comprehensive inspection at Church Road Health Practice on 26 January 2018. We carried out a comprehensive inspection of this service under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider met the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.At this inspection, we found:

• The practice had clear comprehensive systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff had the skills, knowledge, and experience to carry out their roles. The practice had a comprehensive appraisal and development procedure for all administration and nursing staff.

• Staff treated patients with compassion, kindness, dignity and respect.

• The practice organised and delivered services to meet patients’ needs. It took account of patients' needs and preferences.

• Leaders at all levels were visible and approachable. They had the experience, capacity and skills to deliver the practice strategy and address risks to it. They were knowledgeable about issues and priorities relating to the quality and future of services. They understood the challenges and were addressing them.

• Openness, honesty and transparency were demonstrated when responding to incidents and complaints. The provider was aware of and had systems to ensure compliance with the requirements of the duty of candour.

• There was a strong emphasis on the safety and well-being of all staff. The human resources manager explained that part of the personal development review looked at the staff's well-being.

• There were clear responsibilities, roles, and systems of accountability to support good governance and management.

• The practice had a computer system that enabled all staff to quickly and easily access policies, procedures and information about the practice and patients.

• The practice involved patients, the public, staff and external partners to support high-quality sustainable services.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw areas of outstanding practice:

• The practice worked with the department of academic general practice at Queen Mary Westfield Hospital and developed a standard child safeguarding computer template for use in all GP practices in Newham CCG. The lead clinician at Church Road Health had trained other practices including over 150 practice staff in the CCG to use the system correctly and trained practices to appropriately manage safeguarding issues. Within the practice, they had developed a safeguarding team that supported quality improvement and had a whole practice approach to safeguarding. The staff reviewed the patient lists of looked after and safeguarded children. This enabled the identification of 100 children at risk who staff may not have previously identified on the child protection register. In response to the staffs findings, the practice improved staff training and the registration form for new child patients.

• The practice offered a named GP to a local home that accommodated patients with behaviours that challenged, who had a learning disability. The GPs visited the home, telephoned, or used video conferencing to assess patients. If patients visited the surgery risk assessments were in place and these included specific waiting instructions for reception. The patient’s had met the GP to reduce stress. In addition, the GP held an additional multidisciplinary meeting with the hospital team and home staff to ensure they met patients' needs. The care home staff described how the GP had worked with the staff at the home to develop a protocol for staff to follow to reduce the patient’s hospital admissions.

• Leaders had an inspiring shared purpose, and strove to deliver and motivate staff to succeed. There were high levels of satisfaction across all staff. There is a strong organisational commitment and effective action towards ensuring that there was equality and inclusion across the workforce. The practice had a comprehensive appraisal and development procedure for all administration and nursing staff, This had resulted in 26 staff progressing or moving on from the organisation and had provided payment for the course and protected time In addition, the practice had an admin/reception ‘bank’ scheme in which they offered a four-week training programme for people from the local community to get experience and basic training in what is involved in working in a GP practice.

Professor Steve Field (CBE FRCP FFPH FRCGP)Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Bhupinder Kohli & Ms Susan Paul’s practice on the 11 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing, effective, caring, responsive and well-led services. The practice required improvement for providing safe services. It was also good for providing services for older people, people with long term-conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of those relating to the recruitment of staff.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

We saw one area of outstanding practice:

• The practice engaged in funded projects by the Department of Health such as the GP champions for youth working with Newham Asian Woman’s Project to provide support to young people in accessing primary medical services. The lead GP met with local groups of young people as a speaker to explain how to use the NHS online services. The practice put up messages on their waiting room plasma screens to improve the confidence of young people to encourage them to make contact and communicated messages about respecting confidentiality and access to contraception advice.
• Governance and performance management arrangements were proactively reviewed and reflected best practice.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider must:

• Ensure that locum GPs who work at the practice receive Level 3 child protection training.
• Ensure that recruitment checks have been completed for staff before the start of their employment.

In addition the provider should:

• Ensure non-emergency medication is not stored with the emergency medicines and ensure all medication is within its expiry date.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice