Letter from the Chief Inspector of General Practice

We previously inspected Dr Halina Obuchowicz’s practice on 22 June 2016. The overall rating for the practice was inadequate, with ratings of inadequate for the key questions of safe and well-led, and ratings of requires improvement for the key questions of effective, caring and responsive. The practice was placed in special measures for a period of six months. We then carried out a follow up inspection on 7 February 2017. The overall rating for the practice was requires improvement, with ratings for requires improvement for the key questions of safe, effective and well led and the practice was taken out of special measures. The full comprehensive report on the 7 February 2017 inspection can be found by selecting the ‘all reports’ link for Dr Halina Obuchowicz on our website at www.cqc.org.uk.

We carried out an announced focused inspection at Dr Halina Obuchowicz’s practice on 16 November 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 7 February 2017. This report includes our findings in relation to those requirements.

Overall the practice is now rated as good and good for providing safe, effective and well led services.

At this inspection we found:

The practice had made improvements and addressed the issues identified in the previous inspection. Improvements included:

• All staff including locum clinicians had indemnity cover.

• Appropriate recruitment checks were completed for all staff.

• More patients being seen for medical reviews.

• Increased quality assurance work such as audits and acting on patient feedback.

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 the practice of Dr Halina Obuchowicz on 22 June 2016. The overall rating for the practice was inadequate, with ratings of inadequate for the key questions of safe and well-led, and ratings of requires improvement for the key questions of effective, caring and responsive.

The practice was placed in special measures for a period of six months. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Dr Halina Obuchowicz on our website at www.cqc.org.uk.

This inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 7 February 2017. Overall the practice is now rated as requires improvement.

Our key findings were as follows:

• The practice had a clear process in place for reporting and recording significant events.

• There were communication arrangements in place with colleagues to share and discuss significant events, safety alerts, updates to prescribing guidelines and any changes in clinical practice.

• There was improved management of the prescribing of benzodiazepines.

• Security of prescription pads had improved, and index numbers of batches issued to regular locum GPs were recorded.

• Recruitment checks were in place for the majority of staff. Checks we made showed more work was required to fully embed this process.

• Signed, up-to-date Patient Group Directions were in place. Patient Specific Directions where being used when required.

• Checks on the day showed there was no backlog in patient note summarising.

• There had been a number of audits conducted; further work was needed on quality improvement initiatives.

• Figures from the Quality Outcome Framework (QOF) showed achievement of the practice to be higher than or in line with local and national averages.

• Exception reporting was high and on comparison with the previous year’s figures, had increased in some areas. The practice had put measures in place to address this but further work was required in this area.

• Feedback from patients we spoke with was positive; patients told us that they were treated with dignity and respect by all staff at the practice.

• The practice had conducted a survey and updated its website to provide the results of their survey. The practice intended to produce an action plan on how any improvements to services would be implemented.

• A number of improvements had been made in leadership at the practice but further work was required in this area.

There were areas of practice where the provider still needs to make improvements.

Importantly, the provider must:

• Conduct recruitment checks on cleaning staff appointed to clean the practice and

  seek and retain records in respect of locum staff sufficient to confirm their working status and evidence of indemnity cover.

In addition the provider should:

• Conduct work to establish reasons for two consecutive sets of results, lower than local and national averages, on patient satisfaction with GP services.

• Develop evidence of quality improvement initiatives.

• Respond immediately when the process for dealing with significant events is not adhered to by locum staff and share feedback and learning from significant events with locum GPs involved.

• Conduct work to assure that those patients excepted from care interventions are seen quickly, to reduce any negative impact on their health.

I am taking this service out of special measures. This recognises the improvements made so far. The service will be kept under review to ensure further improvements are made and that these are sustained. If the further required improvements are not made we will take the appropriate enforcement action.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We previously inspected Dr Halina Obuchowicz’s practice on 22 June 2016. The overall rating for the practice was inadequate, with ratings of inadequate for the key questions of safe and well-led, and ratings of requires improvement for the key questions of effective, caring and responsive. The practice was placed in special measures for a period of six months. We then carried out a follow up inspection on 7 February 2017. The overall rating for the practice was requires improvement, with ratings for requires improvement for the key questions of safe, effective and well led and the practice was taken out of special measures. The full comprehensive report on the 7 February 2017 inspection can be found by selecting the ‘all reports’ link for Dr Halina Obuchowicz on our website at www.cqc.org.uk.

We carried out an announced focused inspection at Dr Halina Obuchowicz’s practice on 16 November 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 7 February 2017. This report includes our findings in relation to those requirements.

Overall the practice is now rated as good and good for providing safe, effective and well led services.

At this inspection we found:

The practice had made improvements and addressed the issues identified in the previous inspection. Improvements included:

• All staff including locum clinicians had indemnity cover.

• Appropriate recruitment checks were completed for all staff.

• More patients being seen for medical reviews.

• Increased quality assurance work such as audits and acting on patient feedback.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice