We carried out an announced comprehensive inspection at Dr B Sahota & Dr K Cassam (also known as Kingstanding Circle Surgery) on 4 February 2019 as part of our inspection programme.

We last inspection Dr B Sahota & Dr K Cassam in July 2015 we rated the practice as good for providing safe, effective, caring, responsive and well-led services.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as requires improvement overall due to concerns in providing safe and effective services. People with long-term conditions and people experiencing poor mental health (including people with dementia) population groups were rated as requires improvement because the issues identified in effective impacted on these population groups. However, all other population groups was rated as good.

We rated the practice as requires improvement for providing safe and effective services because:

• There was process for monitoring patients’ health in relation to the use of medicines including high risk medicines; however, process were not always carried out effectively.
• A sample of care records we viewed indicated that appropriate monitoring of patients prescribed high-risk medicines was not always carried out in line with the practice processes. Clinicians were not always able to demonstrate that they had accessed all information necessary to provide assurances that medicines remained safe for patients to receive prior to issuing a repeat prescription.
• Following our inspection, the practice provided additional evidence demonstrating they had taken actions to ensure staff were following processes for appropriate monitoring of patients’ health in relation to the use of medicines.
• Patients received care and treatment that generally met their needs. However, the practice could not demonstrate that it had participated fully in care planning for patients.
• The 2017/18 Quality Outcomes Framework (QOF) achievements for the practice showed variation in how the practice was performing compared to local and national averages. The practice was aware of areas which was lower than local and national averages and were taking action. These areas included exception reporting and care management for patients diagnosed with mental health related illness.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.

We rated the practice as good for providing caring, responsive and well-led services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care. The 2018 national GP survey results as well as completed CQC comment cards was aligned with these views.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care in most areas. However, there were areas of the governance arrangements which impacted on the delivery of safe and effective services.

The areas where the provider must make improvements are:

• Ensure that care and treatment is provided in a safe way.

Whilst we found breaches of regulations, the provider should:

• Review arrangements between the practice and other health and social care professionals to ensure clinical care is appropriately communicated.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

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 K Sahota and Dr B Cassam’s Kingstanding Circle Surgery on 8 July 2015. Overall the practice is rated as good.

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.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice facilities were mostly satisfactory and 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.

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

Importantly the provider should:

• Ensure that processes for managing prescription recording, handling, storing and security are strengthened.
• Ensure that all complaints are recorded and action taken is detailed to capture the positive approach staff take in response to resolving patient’s complaints.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice