We carried out an announced comprehensive inspection at Dr Mashru on 25 March 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 found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm. However, the provider should review the need to have a fire alarm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

During our inspection we spoke with the practice manager, a GP (who was also the provider), reception staff and the practice nurse. We also spoke with five people who use the service. Comments included, “Staff are always cheerful and polite” and “I can usually see the doctor of my choice”. Another person said “staff are always polite and well mannered”. However other comments included, “I had a bad experience three weeks ago, I was given a new doctor who was not sympathetic, now I’ve switched to another doctor who is good” and “They rush you in and out, they are all like that and don’t take the time to explain things.”

Information was available to people about the service and people could choose to visit either of the two sites where the staff worked. People could book an appointment or use the walk in service if there was an emergency. This was held for an hour each weekday morning at the Ruislip site. This was only available for people registered at the service.

We viewed the systems in the service to ensure, where necessary, people were appropriately referred on to specialists for further investigations and/or treatment.

Safeguarding procedures were in place. However, some staff had not received adequate training to recognise the signs of possible abuse in both children and adults. Furthermore the service did not have a whistle blowing policy and procedure in place.

Staff had received adequate support and training to ensure they were able to meet the needs of the people using the service. However, we did not see evidence of all the training staff completed or attended and we could not verify that all staff received an annual appraisal.

The provider had procedures for monitoring the quality of services provided to people using the service.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 22 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 and well managed.
• 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, although the results of the GP survey were below local and national averages in some areas.
• 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 should make improvement are:

• Review the national GP patient survey with the aim of improving patient satisfaction.

• Review the arrangements in place to ensure they can meet the needs of patients with poor hearing.

• Improve the process for complaints management.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice