We carried out an announced comprehensive inspection at Dr Joseph Arayomi on 15 January 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We rated the practice as requires improvement for providing safe services because:

• Recruitment processes were not consistent and did not always follow national guidance.
• Although there was a procedure for the security of prescription paper this was not always followed.
• The practice had significant events as a standing item on meeting agendas however minutes did not demonstrate that discussion and learning had occurred.

We rated the practice as good for providing effective, caring, responsive and well-led services because:

• The practice was aware of its performance and had identified where improvement was required. The practice had plans in place to effect these changes.
• There was evidence of improvements to the level of care and treatment experienced by patients. The practice was aware further progress was needed to sustain this.
• Feedback from patients about the care provided and the attitude of staff was positive.
• Patients found it easy to make appointment.
• The practice were aware of their patient population and worked to ensured that services provided reflected their needs.
• Leaders were visible and staff felt supported by them.
• There was evidence of good teamwork and a culture that made staff feel able to raise concerns and suggestions for improvement. Staff had confidence that these would be considered.

The areas where the provider must make improvements are:

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Review the business continuity plan, where copies are stored and make sure all staff are aware of it.
• Review the implementation of procedures around prescription paper security and ensure that all policies are personalised to the practice.
• Review the audit trail demonstrating learning and dissemination of complaints and significant events.
• Review processes for engaging patients and carers to improve uptake of childhood immunisations and screening rates for all types of cancer screening.
• Continue to improve outcomes for patients with Chronic Obstructure Airways Disease (COPD) and overall patient experience whilst in consultations.
• Ensure that staff are aware of and involved in the practice’s vision and strategy.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We conducted a comprehensive announced inspection on 13 March 2015.

Specifically, we found the practice to be good for providing effective, caring, responsive and well-led services. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances, and people experiencing poor mental health (including people with dementia). It required improvement for providing safe services.

Our key findings were as follows:

• Staff understood and their responsibilities to raise concerns, and to report incidents. Information about safety was recorded, monitored, appropriately reviewed, addressed and shared with staff during meetings.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned for.
• 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 readily available and easy to understand.
• 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.

However, there was an area of practice where the provider needed to make improvements.

 The provider should:

• Implement a system for reporting and investigating incidents of a less serious nature and near misses as part of improving safety within the practice.

• Carry out regular checks to ensure that cleaning tasks are completed to a satisfactory standard.

• Improve records including minutes form internal and external meetings so that they reflect discussions, actions and any learning outcomes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice