Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mohammed Nasir Imam’s practice on 23 September 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff we spoke with understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. We saw evidence to demonstrate that learning was shared amongst staff.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice worked closely with other organisations in planning how services were provided to ensure that they meet patients’ needs.
• We saw evidence to demonstrate that the practice had carried out an analysis of its patient population profile and developed targeted services and made changes to the way it delivered services as a consequence. For example by offering more in-house services such as diabetes care or 24 hour blood pressure monitoring.
• Risks to patients were assessed and well managed.
• Feedback from patients about their care was consistently positive. Patients we spoke with told us 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Most patients said they found it easy to make an appointment and there was continuity of care, with urgent appointments available the same day.
• 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:

• Further progress the steps taken to improve appointment access and appointment waiting times.

• Consider the further promotion of national screening programmes in order to support the improvement of uptake.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

At our last inspection in July 2013, we identified that the arrangements for dealing with safeguarding, medical emergencies and fire safety were inadequate and could put people at risk. The provider did not have a robust system in place for monitoring the quality of service provision. At the time of the inspection, we judged that this had a moderate impact on people who used the service. We set compliance actions and told the provider to take action.

The purpose of this inspection was to see if improvements had been made since our last inspection in July 2013. We gave the provider short notice of our inspection so that any disruption to people's care and treatment were minimised. During the inspection we spoke with six people who used the service. This included people who were part of the patient participation group (PPG). The registered provider who was also a GP was on leave at the time of our inspection. However, we spoke with the practice manager and four members of staff, this included clinical staff.

People who required the use of a wheelchair were able to access the service. One person told us, “Staff are very helpful if people have wheelchairs they will get the ramp to help them in".

There were arrangements in place to deal with foreseeable emergencies.

Staff had the information they needed to act on any safeguarding concerns about children and vulnerable adults.

The provider had an effective system to regularly assess and monitor the quality of service that people received. One person told us, "I have no concerns or complaints, the service is very good".

When we inspected the practice, the GP and practice manager advised us that they had recently returned to the premises after a year’s absence while repairs had been carried out on the building. They explained that this had caused some interruption to the service which they were now trying to re-establish.

During our inspection we spoke with seven people who used the service. One of the people we spoke with was also a member of the Patient Participation Group (PPG). We also spoke with five members of staff including the GP who was also the registered provider.

Some of the people we spoke with raised issues about waiting times but overall were complimentary about the service and told us that this was improving. Comments we received from people included: “I’ve been with them for 25 years, I have no issues. They have never let me down” and “It’s a good practice.”

People told us that they were treated with dignity and respect. People felt they were given enough time to discuss their health needs and felt involved in decisions about their treatment. Where communication barriers existed staff supported people to ensure their health needs were met.

People received medicine reviews to help protect them from the risks associated with medicines. Medicines administered on site were stored appropriately to ensure their effectiveness. However, the arrangements for dealing with safeguarding, medical emergencies and fire safety were inadequate and could put people at risk.

The provider had some systems in place for monitoring the quality of service provision. However these were not well established and further work was needed to demonstrate compliance with this outcome.