Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Raja Segar Ramachandram, known as Moor Green Lane Medical Centre, on 6 December 2016. Overall the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events. Incidents and significant events were discussed in weekly meetings as well as monthly meetings where all staff came together to consolidate learning.
• There were measures in place to safeguard children and vulnerable adults from abuse. We confirmed that these were in line with current legislation and local requirements. Staff we spoke with knew how to escalate concerns.
• The practice had a system for managing patient safety alerts issued by external agencies including the Medicines and Healthcare products Regulatory Agency (MHRA). We checked a sample of recent alerts and found that action had been taken as a result, but one member of clinical staff we spoke with was not aware of a recent alert that had been actioned.
• Non-clinical staff checked uncollected prescriptions and returned these to the GPs to ensure any patients who needed their medicine urgently were followed up with.Staff had access to up to date evidence based guidance. New guidance was discussed at clinical meetings, to ensure the care and treatment provided met patients’ needs.
• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were higher than CCG and national averages.
• The practice had a program of clinical audit. This was used in conjunction with benchmarking to monitor and improve the quality of patient care.
• Staff demonstrated that they had the skills, knowledge and experience to deliver effective care and treatment.
• Results from the National GP Patient Survey published in July 2016 showed that the practice’s performance in patients’ satisfaction with the practice staff and the care they received was above average.
• We observed staff to be kind and helpful to patients and to treat them with dignity and respect.
• Information was available to help patients understand the complaints system. There was an up to date complaints and comments leaflet displayed in the patient waiting area and this had a feedback form attached. Details of how to complain were also included in the practice leaflet and on the website.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff found the GPs and practice manager approachable and said there was a small friendly culture in the practice.
• The practice was aware of the requirements of the duty of candour and systems were in place to ensure compliance with this.
• The practice was committed to continuous learning and improvement and actively sought feedback from staff and patients.

We saw one area of outstanding practice:

• The practice published an annual quality account on its website to inform patients and the public about its performance over the previous year and strategy for the coming year. This was also used to communicate initiatives with patients, such as reducing medicines wastage.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with eight patients, the registered provider (the lead GP), the practice manager, a practice nurse, the health care assistant and a receptionist.

Patients' needs were assessed and care and treatment was planned and delivered in line with their individual wishes. Patients told us they were treated with care and respect and provided positive feedback. One patient told us: “I just think generally the patients are at the heart of this practice and care is paramount”. We spoke with another patient about the care their relative received. They said: “I just know whoever she sees she'll have good treatment”. The patients we spoke with told us that obtaining repeat prescriptions had not been a problem. We found that referral of patients to hospitals had been made promptly and efficiently.

Staff had received training in the safeguarding vulnerable of adults and children. They were aware of the appropriate agencies to refer safeguarding concerns to so that patients were protected from harm.

We found that the premises were appropriate and all areas of the practice were seen to be hygienic and well organised. There was a cleaning schedule in place and regular audits had been carried out to check the standards of hygiene.

The practice had an effective system to regularly assess and monitor the quality of the rest of the service that patients received. All patients spoken with were complimentary about the services they received.