Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Goyal and Associates Practice on 5 September 2016 The overall rating for the practice was good. The full comprehensive report on 5 September 2016 inspection can be found by selecting the ‘all reports’ link for Dr Goyal and Associates on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 8 March 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 5 September 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our key findings were as follows:

• The practice had records in place to demonstrate that emergency drugs were being monitored regularly.

• Risks to patients were well assessed, for example, staff protected patient’s confidentiality by removing their smart cards when vacating computer terminals.

• The practice had a carer’s identification protocol and the practice’s computer system alerted GPs if a patient was a carer or had a carer. The practice had identified 75 patients as carers (more than 1% of the practice list). A generic letter which encouraged patients to identify themselves as carers was also introduced and was sent out to patients when sending other communication for example reminder letters.

• Following the comprehensive inspection, the practice implemented an uncollected prescription policy which was managed by the GP and maintained by reception staff. Uncollected prescriptions were audited by way of a register including patient ID, date on prescription, outcome and date prescriptions were destroyed.

• The practice could demonstrate that fire drills had been carried out, however improvements were needed to ensure patient safety.

At our previous inspection on 5 September 2016, we rated the practice as requires improvement for providing safe services based on our findings which included issues around emergency drugs and repeat prescription management. At this inspection we found that the issues found during the previous inspection had been addressed. Therefore, the practice is now rated as good for providing safe services.

The area where the provider should make improvement is:

• Ensure staff designated has fire wardens are adequately trained to understand their roles and responsibilities when undertaking fire drills.

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 Goyal & Associates on 5 September 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected 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 however some improvements were required around managing those risks.
• 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.
• 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 and was well 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Protect patient confidentiality by ensuring all staff remove smart cards when vacating computer terminals.

• Review process for recording and monitoring stocks of emergency medicines to ensure records are correct and up to date.

The areas where the provider should make improvement are:

• Mitigate risks to patients by ensuring uncollected prescriptions are checked and followed up with patients.

• Ensure regular fire drills are carried out.

• Ensure carer’s needs are met by introducing a carer’s register and a system to alert staff when a patient is also a carer.

Professor Steve Field CBE FRCP FFPH FRCG

Chief Inspector of General Practice