Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Abdul-Razaq Abdullah on 4 August 2016. The practice was rated requires improvement for providing effective and well-led services, this resulted in an overall rating of requires improvement. The full comprehensive report for the 4 August 2016 inspection can be found by selecting the ‘all reports’ link for Dr Abdul-Razaq Abdullah on our website at www.cqc.org.uk.

This inspection was an announced focussed follow-up carried out on 24 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 4 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The ratings for providing effective and well-led services are now good resulting in an overall rating of good for this practice.

Our key findings were as follows:

• There was a system in place for monitoring staff appraisals, all staff had been appraised or were scheduled to be appraised at the time of our visit.

• The practice provided a completed two-cycle clinical audit that was completed within the last 12 months.

• The practice has shown improvement for several indicators in patient outcomes for diabetes.

• Outcomes were still below national and local averages for one diabetes indicator and for hypertension; however the practice has employed three nurses and increased clinical consulting space to improve patient outcomes.

• The practice has reduced the rate of exception reporting overall apart from two areas: cervical screening and mental health care planning. The practice has increased the number of clinical staff and clinical consulting space to improve patient engagement and reduce exception reporting for these areas.

• More than one per cent of patients at the practice have been identified as carers. The practice had a comprehensive information leaflet detailing support services available to carers.

• The practice provided evidence that internal clinical meetings were recorded.

• The practice discussed patients’ satisfaction with the Patient Participation Group. Patient satisfaction in relation to accessing the practice by phone was comparable to other practices in the area.

• The practice had a contract in place for annual calibration and portable electrical appliance testing.

• The practice had updated their business continuity plan; the plan included emergency contact details.

At our previous inspection on 4 August 2016, we rated the practice as requires improvement for providing effective and well-led services as there were no completed clinical audits, not all staff had been appraised and outcomes for patients with long-term conditions such as diabetes and hypertension required improvement. At this inspection we found that the practice had put focus on quality improvement by completing a two-cycle clinical audit. We found that outcomes for patients with long term conditions had mostly improved and additional clinical consulting space and clinical staff had been sourced to allow for further improvements. We also found that the practice had updated and improved the appraisal system and all staff had been appraised or had been scheduled for an appraisal.

However there were areas of practice where the provider should make improvements:

• The practice should continue to review and improve outcomes for patients with long term conditions, particuraly those with hypertension and diabetes.

• The practice should consider ways to improve patient engagement in health checks for cervical screening and mental health care planning.

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 Abdul-Razaq Abdullah on 4 August 2016. The practice was rated requires improvement for providing effective and well-led services, this resulted in an overall rating of requires improvement. The full comprehensive report for the 4 August 2016 inspection can be found by selecting the ‘all reports’ link for Dr Abdul-Razaq Abdullah on our website at www.cqc.org.uk.

This inspection was an announced focussed follow-up carried out on 24 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 4 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The ratings for providing effective and well-led services are now good resulting in an overall rating of good for this practice.

Our key findings were as follows:

• There was a system in place for monitoring staff appraisals, all staff had been appraised or were scheduled to be appraised at the time of our visit.

• The practice provided a completed two-cycle clinical audit that was completed within the last 12 months.

• The practice has shown improvement for several indicators in patient outcomes for diabetes.

• Outcomes were still below national and local averages for one diabetes indicator and for hypertension; however the practice has employed three nurses and increased clinical consulting space to improve patient outcomes.

• The practice has reduced the rate of exception reporting overall apart from two areas: cervical screening and mental health care planning. The practice has increased the number of clinical staff and clinical consulting space to improve patient engagement and reduce exception reporting for these areas.

• More than one per cent of patients at the practice have been identified as carers. The practice had a comprehensive information leaflet detailing support services available to carers.

• The practice provided evidence that internal clinical meetings were recorded.

• The practice discussed patients’ satisfaction with the Patient Participation Group. Patient satisfaction in relation to accessing the practice by phone was comparable to other practices in the area.

• The practice had a contract in place for annual calibration and portable electrical appliance testing.

• The practice had updated their business continuity plan; the plan included emergency contact details.

At our previous inspection on 4 August 2016, we rated the practice as requires improvement for providing effective and well-led services as there were no completed clinical audits, not all staff had been appraised and outcomes for patients with long-term conditions such as diabetes and hypertension required improvement. At this inspection we found that the practice had put focus on quality improvement by completing a two-cycle clinical audit. We found that outcomes for patients with long term conditions had mostly improved and additional clinical consulting space and clinical staff had been sourced to allow for further improvements. We also found that the practice had updated and improved the appraisal system and all staff had been appraised or had been scheduled for an appraisal.

However there were areas of practice where the provider should make improvements:

• The practice should continue to review and improve outcomes for patients with long term conditions, particuraly those with hypertension and diabetes.

• The practice should consider ways to improve patient engagement in health checks for cervical screening and mental health care planning.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

People said the clinicians explained treatment and tests to them in a way they could understand and they were able to give their own views. One person said "the doctor is really good (at) listening to me." They said they were usually able to get appointments on the same day. If not they, they were able to get an appointment within a week.

People's needs were assessed and care and treatment was planned and delivered in line with their individual treatment plan. Comments included "they're very supportive" and "they're very good. I can't fault one of them."

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Comments included "yes, I feel very safe" and "I have never felt uncomfortable with any person." There were effective systems in place to reduce the risk and spread of infection. People said that the premises were clean and they were satisfied with the hygiene practices of clinical staff. One person said "the hygiene's alright. The doctor washes his hands."

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We spoke with the chairperson of the Patient Reference Group (PRG) who said "most definitely" when asked if the service invited them to give their views about the quality of the service offered.