Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 8 July 2015 – Good)

The key questions are rated as:

Are services safe – Good

Are services effective – Good

Are services caring – Good

Are services responsive – Good

Are services well-led - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Dr Jasjeet Dua Surgery on 13 December 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Continue to implement processes to increase their numbers of identified carers in order for them to receive appropriate care and support.

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 Kensington Park Medical Centre on 8 July 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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. The practice had effective systems in place to manage risks staff recruitment, infection control, child protection and safeguarding and medical emergencies.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. We found that care for long-term conditions such as diabetes was being managed effectively in the community and care was provided in partnership with other specialist and community services.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice tended to score above average in the national GP patient satisfaction survey.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment although it was not always possible to see the same GP regularly. Feedback was positive about access to the service, with national patient survey scores being above average for this aspect of care.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff were supported by management. The practice proactively sought feedback from patients and staff, which it acted on. Staff told us they were well supported and had access to the training they needed to develop in their role.

We saw one area of outstanding practice:

• The practice made use of information technology to upload, share and discuss dermatological cases remotely with the relevant hospital consultants. This reduced the need for patients to attend additional outpatient appointments. The practice also made innovative use of information technology to routinely update patient notes by voice command. The doctors told us this greatly improved their efficiency and enabled them to spend more face to face time with their patients.

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

• Establish a functioning patient participation group to support the practice in engaging and learning from patient experience.
• Encourage staff to record incidents, good and bad, to promote improvement and learning.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Dr Jasjeet Dua provides primary care services at Kensington Park Medical Centre in West London. The practiceprovides care to a diverse local community of approximately 6500 patients. Services provided include antenatal care, child health and immunisation, sexual health, chronic disease management and end-of-life care. The practice is registered with the Care Quality Commission to provide the following regulated activities: diagnostic and screening procedures; family planning; maternity and midwifery services; surgical procedures; and, treatment of disease, disorder or injury.

We collected 23 comment cards that patients had completed in advance of the inspection visit and spoke with five patients attending the practice on the day of the inspection. All the patients who gave feedback were happy with the quality of care they received and many praised individual staff members.

The practice provided a safe service with systems in place to manage risks associated with infection control, medicines management, staff recruitment, child protection and adult safeguarding and medical emergencies. There were mechanisms to investigate and learn from incidents and complaints.

Patients’ needs were assessed and treatment and referral patterns were in line with current guidelines and best practice. Staff participated in collaborative clinical audits and external peer group meetings and used this evidence to improve. Staff were encouraged to develop their professional practice and skills and received an annual appraisal. The lead GP

Patients told us the practice was caring. Patients who participated in the inspection were happy with the service they received at the practice. They said they were involved in decisions about their treatment. We observed that reception staff were polite and respected patients’ privacy. The practice operated a chaperone service but had not yet trained staff acting as chaperones on this role.

The practice was responsive to the needs of its patients. The practice provided services tailored to particular patient groups and routinely booked interpreters for patients who did not speak English as a first language. The practice had explored different ways for patients to access the service and patients told us they did not usually have difficulties making an appointment when they needed one. The practice promoted health and the prevention of illness with written information in the waiting room, services such as smoking cessation advice and targeted advice for patients with particular health conditions.

The practice ethos was to put patients first and provide a high quality service. There were governance arrangements in place and an open reporting culture. Staff members told us they benefitted from excellent clinical and managerial leadership within the practice and said this had a positive impact on the quality of care. The practice obtained feedback from patients through surveys, informal feedback and complaints and used this to improve the service. However, the practice did not have a patient participation group.