This practice is rated as Good overall.

The previous inspection was in August 2015 and the practice was rated Good.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced inspection at Dr Sajid Zaib, more commonly known as Oakfield Surgery, in Aylesbury, Buckinghamshire on 29 November 2018 as part of our inspection programme.

At this inspection we found:

• The practice had 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 routinely reviewed the effectiveness and appropriateness of the care it provided. This included a programme of quality improvement activities including clinical audits. The practice ensured that care and treatment was delivered according to evidence-based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they could access care when they needed it.

• The practice had good facilities and was well equipped to treat patients and meet their needs. The premises were clean and hygienic.

• There was a strong focus on continuous learning and improvement at all levels of the organisation. This included supporting the next generation of staff in primary care, for example GP Registrars and student nurses.

The areas where the provider

should

make improvements are:

• Provide awareness training for all staff on the ‘red flag’ sepsis symptoms that might be reported by patients and how to respond appropriately.

• Complete and record annual fire drills and fire evacuation procedures.

• Look at methods to improve the uptake of cervical screening for eligible patients.
• Review the practice computer and internal systems to ensure all documents and correspondence are easily and readily available.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Sajid Zaib (Oakfield Surgery) on 12 August 2015. Overall the practice is rated as good.

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

• We found the practice had made improvements since our last inspection on 17 December 2014 and they were meeting regulations relating to the management of medicines, recruitment, staffing and infection control that had previously been breached.
• 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.
• 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 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.
• 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 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 practice demonstrated a strong commitment and constructive support to the three GP Registrars who were undertaking additional training at the practice, whilst gaining experience and higher qualifications in general practice and family medicine.

• The practice had an effective governance system in place, was well organised and actively sought to learn from previous CQC inspections, performance data, complaints, incidents and feedback.
• The practice had a clear vision that had improvement of service quality and safety as its top priority. The practice fully embraced the need to change, high standards were promoted and there was good evidence of team working

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We undertook a comprehensive inspection of Dr Sajid Zaib (Oakfield Surgery) on 17 December 2014. We have rated the overall practice as requires improvement. The practice was rated inadequate in safe, requires improvement in effective and well led and good in the caring and responsive domains.

Our key findings were as follows:

The practice is rated as inadequate for providing safe services and improvements must be made.

Patients were at risk of harm because systems and processes had not been implemented in a way to keep them safe. For example, concerns were found in recruitment processes, medicine management, infection control and staff training.

Generally the feedback from patients was positive. Patients we spoke with said they were happy with the service they received. Patients were complimentary of the practice staff. Most patients were happy with the appointment system and all knew they could speak to a doctor or a nurse over the phone whenever they needed to.

Patient’s needs were assessed and care was planned and delivered in line with current legislation. This included assessing capacity and promoting good health.

Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.

The practice had a business development plan. This set out the practice values, aims and objectives for the next five years. The practice sought feedback from staff and patients, which it acted on.

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

Importantly, the provider must:

• Ensure all recruitment and employment information required by the regulations are documented in all staff members’ personnel files.
• Ensure staff receive regular appropriate training, specific to their role. This includes, training in, safeguarding, infection control and chaperoning.
• Ensure medicine management systems are reviewed and reflect national guidelines.
• To ensure robust quality and monitoring systems are in place.
• Ensure appropriate infection control systems are in place, in line with national guidelines.

In addition the provider should:

• To review safeguarding processes to ensure all staff have the knowledge and skills appropriate to their level.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice