Letter from the Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Asma Moghal practice, Becontree Medical centre on 11 March 2016. The overall rating for the practice was requires improvement and the practice therefore needed to be re-inspected within six months after the report was published. The full comprehensive report published on 27 May 2016 can be found by selecting the ‘all reports’ link for Dr Asma Moghal on our website at www.cqc.org.uk.

This inspection was undertaken following the period of six months and was an announced comprehensive inspection on 17 November 2016 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 11 March 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed and the practice had acted upon the findings of our previous inspection in relation to patient safety.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• The majority of patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities in a purpose-built building and was well equipped to treat patients and meet their needs.
• There was a leadership structure and staff felt supported by management.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Continue to review system to identify carers in the practice.
• Make patient information leaflets available in other languages spoken by patients in the practice.
• Ensure patients are aware that translation services are available.

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 Moghal’s Practice on 11 March 2016. Overall, the practice is rated as requires improvement.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to inform practice management about incidents and near misses. However, the records of these events were brief and learning outcomes were minimal. There was no evidence to show patients received an apology.
• Risks to patients were assessed and managed, with the exception of those relating to recruitment checks and infection control.
• Data showed patient outcomes were comparable to the national average. We saw no evidence of completed audits having been carried out and we saw no evidence that audits were driving improvements to patient outcomes.
• The majority of patients said they were treated with compassion, dignity and respect.

• Urgent appointments were usually available on the day they were requested. However, patients reported that they did not receive timely care when they needed it.
• There was limited information about services. Translation services were available when requested.
• The practice had a number of policies and procedures to govern activity, but some were generic and did not have practice specific information or were overdue a review.

The areas where the provider must make improvements are:

• Ensure that patients affected by significant events receive reasonable support and follow up.
• Ensure a programme of quality improvement including clinical audits is in place to improve outcomes for patients.
• Ensure patient group directions (PGDs) are completed and up to date in line with legislation.
• Ensure staff understand their responsibilities in relation to the Mental Capacity Act 2005.
• Ensure that recruitment checks comply with Schedule 3 requirements.
• Ensure infection prevention and control audits are carried out annually by trained staff.
• Ensure that all documents and processes used to govern activity are practice specific and are up to date. Including, updating the Business Continuity Plan.
• Ensure the appointment system is reviewed to improve patient access.
• Ensure there are systems in place to monitor blank prescriptions.
• Ensure risk assessments for DBS are carried out for staff who carry out chaperoning duties.
• Ensure that the complaints procedure is reviewed to comply with regulations.
• Ensure systems are in place to seek and act on feedback from patients for the purpose of evaluating and improving services.

In addition the provider should:

• Develop, document and communicate to all staff the practice vision, strategy and supporting business plan.
• Revise the support mechanisms available to staff and provide arrangements for all staff to attend formal meetings.
• Review system to identify carers in the practice.

Where a service is rated as inadequate for one of the five key questions or one of the six population groups or overall, it will be re-inspected within six months after the report is published. If, after re-inspection, the service has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group or overall, we will place the service into special measures. Being placed into special measures represents a decision by CQC that a service has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice