Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr N Raichura and Dr J Mehta on 29 June 2015. After the comprehensive inspection, the practice was rated as good with requires improvement in safe services. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dr. N Raichura & Dr. J Mehta on our website at www.cqc.org.uk. We undertook a focussed follow up inspection on 22 July 2016 to check that improvements had been made. The practice is rated as good for providing safe services and rated good overall.

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. These included regular infection control audits and actions were taken/planned to address any improvements identified as a result.
• The practice had ensured that risks associated with dispensing medicines were robustly recorded and mitigated. Medicines were stored securely and the security for the issue and tracking of blank prescription forms reflected nationally accepted guidelines as detailed in NHS Protect.
• The practice had ensured practice recruitment guidance included all members of staff including those classed as locums.
• 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.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The provider was aware of and complied with the requirements of the duty of candour.

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 N Raichura and Dr J Mehta on 29 June 2015. Overall the practice is rated as good.

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

Our key findings were as follows:

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• Patients told us that the continuity of GPs was a good feature of the practice, although some told us that waiting times at urgent appointments could be long.
• The security of medicines and recording of risk in the dispensary was not robust.

We saw an area of outstanding practice:

• The practice had a higher than average population of both patients who were older and lived in nursing homes. The number of patients at the practice who lived in a nursing home was six times the national average. The practice was responsive to the needs of patients in this group by a regular GP visiting each home at least twice a week. They worked in partnership with the clinical commissioning group (CCG) pharmacist and care home staff to ensure that patients’ needs were met. For example, on admission to a nursing home a patient’s full medical history, blood screening and medicines review was undertaken by the GP in a half hour visit and ongoing treatment plan decided. The practice received no extra finance for this care provision and saw it as part of the service that had work effectively for a number of years.

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

Importantly, the provider must:

• Improve the storage of medicines within the practice.
• Ensure that risks associated with dispensing medicines are robustly recorded and mitigated.

In addition the provider should:

• Act on outstanding actions from the most recent infection prevention control audit and introduce a regular practice initiated cycle of infection prevention control audits.
• Consider documenting discussions from Multi-Disciplinary Team (MDT) meetings to ensure actions are recorded and followed.
• Ensure practice recruitment guidance includes all members of staff including those classed as locums.

Improve security for the issue and tracking of blank prescription forms to reflect nationally accepted guidelines as detailed in NHS Protect.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice