Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the practice on 20 January 2015, when we found breaches of legal requirements.

After the comprehensive inspection, the practice wrote to us to say what actions would be taken to meet the legal requirements in relation to the breaches of regulations 9 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to person-centred care and good governance.

We undertook this focussed inspection on 8 December 2015 to check that the planned actions had been implemented and to confirm that the practice now met the legal requirements. This report covers our findings in relation to those requirements.

We found that the practice had taken appropriate action to meet the requirements of the regulations.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Dr Dineshwar Prasad on our website at www.cqc.org.uk.

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 Dineshwar Prasad on 20 January 2015. Overall the practice is rated as requires improvement.

We found the practice required improvement in providing a safe, effective and well-led service but was good at providing a caring and responsive service. In addition the practice required improvement for providing services for the six population groups; 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 their responsibilities to raise concerns, and to report incidents and near misses.
• Data showed patient outcomes were average for the locality.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments usually available the same day.
• Fifty eight percent of 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.
• The practice did not hold regular governance meetings but clinical issues were discussed at ad hoc meetings.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

The areas where the provider must make improvements are:

• Ensure the leadership structure operates effectively to ensure governance arrangements are effectively monitored to identify risk and deliver all improvements.
• Ensure a safe and effective system is in place for the processing of patient test results.
• Ensure safeguarding processes are effective and known by all staff.

In addition the provider should:

• Improve the effectiveness of practice meetings ensuring all staff are involved.
• Ensure all staff who act as a chaperone to patients are suitably trained.
• Ensure arrangements are in place for the clinical supervision and annual appraisal of the practice nurse.
• Ensure there is a formal risk assessment in place to cover incidents of hypoglycaemia and epileptic seizure.
• Ensure all staff have an appropriate working knowledge of the Mental Capacity Act 2005 and consent.
• Ensure patient consultations are always conducted in private.
• Ensure the Legionella risk assessment covers all appropriate checks.
• Ensure recruitment arrangements include all necessary pre-employment checks for all staff.
• Ensure formal arrangements are in place for access and use of an automated external defibrillator (AED).
• Ensure information available to patients on the practice website is relevant to those patients living in England.
• Ensure care plans contain all relevant information such as the patients health goals, future treatment plans and any specific care needs.
• Ensure all staff receive appropriate training in the use of the practice computer system to demonstrate competence in the recording and location of electronic documents as appropriate to their role and responsibilities.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice