This practice is rated as Requires Improvement overall.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at Dr Chidambaram Balachander on 4 December 2018 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 was meeting 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:

• There was an effective system for reporting and recording significant events.
• The practice’s systems, processes and practices did not always help to keep people safe.
• Risks to patients, staff and visitors were not always assessed, monitored and managed in an effective manner.
• Staff did not always have the information they needed to deliver safe care and treatment to patients.
• The arrangements for managing medicines in the practice did not always keep patients safe.
• The practice learned and made improvements when things went wrong.
• Performance for diabetes and hypertension related indicators for 2017 / 2018 was significantly below local and national averages. However, the practice was taking action to make improvements.
• Published results showed the childhood immunisation uptake rates for the vaccines given exceeded World Health Organisation targets of 95%.
• Published QOF data from 2017 / 2018 showed that the practice’s exception reporting for some indicators was higher than local and national averages, significantly so in some cases.
• Staff had the skills, knowledge and experience to carry out their roles. However, not all staff were up to date with essential training.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
• Results from the national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was higher than local and national averages, significantly so in some cases.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.
• Governance arrangements were not always effective.
• Some processes to manage current and future performance were not yet sufficiently effective.
• The practice involved patients, the public, staff and external partners to support high-quality sustainable services.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

The areas where the provider should make improvements are:

• Continue with plans to set up a patient participation group.

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

Please refer to the detailed report and the evidence tables for further information.