We carried out an announced focused inspection at Dr Khalid Patel (also known as Goodmayes Medical Practice) on 24 January 2019 as part of our inspection programme.

At the last inspection in November 2017 we rated the practice as requires improvement for providing safe services because:

• The practice did not have oversight of some clinical activities conducted by the healthcare assistant and the locum practice nurse around medicines management.

At this inspection, we found that the provider had satisfactorily addressed this area.

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

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

We have rated this practice as good overall, with key question safe now rated good.

We rated the practice as good for providing safe services because:-

• The practice had systems and processes in place which allowed the healthcare assistant and physicians associates to administer medicines using a patient specific direction (PSD).
• The practice had systems and processes in place which allowed the locum practice nurse to administer medicines using a patient group direction (PGD).

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

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

The last inspection of this practice took place in September 2015. The overall rating for the practice at that time was good, with the exception of key question safe which was rated as requires improvement. Our concerns at this time related to out-of-date and incomplete training for some members of staff, which included expired safeguarding training and chaperoning duties being undertaken by staff who had been trained to do so. Following the September 2015 inspection, we issued the practice a requirement notice in respect of Regulation 18 of the Health and Social care Act (RA) Regulations 2014.

At this inspection, the key questions are rated as:

Are services safe? – Requires Improvement

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 Khalid Patel (also known as Goodmayes Medical Practice) 29 November 2017. This inspection was carried out to review in detail the actions taken by the practice to improve the quality of care and to confirm that the practice was now meeting legal requirements following the September 2015 inspection.

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 did not always routinely review the effectiveness and appropriateness of the care it provided, with regards to the duties conducted by the practice healthcare assistant. The practice did ensure that care and treatment was delivered according to evidence- based guidelines.
• Not all patents were happy with care provided by the nursing team at the practice.
• 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 focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients

The areas where the provider should improvements are:

• To review the results from the Nation GP Patient Survey with particular reference to patient satisfaction on gaining timely access to services provided.

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 Khalid Patel (also known as Goodmayes Medical Practice) on 9 September 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.
• Risks to patients were assessed and well managed.
• 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. However, some staff training on adult and child safeguarding had expired.
• Staff were acting as chaperones but had not received formal training.
• 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. However, there was no information about the translation services available to patients.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. The practice also had a telephone triage system in place to assist patients requiring urgent advice.
• 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.

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

The areas where the provider must make improvements are:

• Ensure that staff have received the appropriate training, including on chaperoning, and adult and child safeguarding.

Importantly they should:

• Arrange for electrical equipment to be tested for safety at appropriate intervals.
• Put a system in place to monitor the movement and use of prescription pads in the practice.
• Raise awareness of the translation services available for patients.
• Review the appointment system and consider changes to improve patient access.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice