This practice is rated as Requires Improvement overall. (Previous inspection report published 23/03/2016 – Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Requires Improvement

Are services responsive? – Requires Improvement

Are services well-led? - Requires Improvement

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Requires Improvement

People with long-term conditions – Requires Improvement

Families, children and young people – Requires Improvement

Working age people (including those recently retired and students – Requires Improvement

People whose circumstances may make them vulnerable – Requires Improvement

People experiencing poor mental health (including people with dementia) - Requires Improvement

We carried out an announced comprehensive inspection at Partington Central Surgery on 20 February 2018 as part of our inspection programme.

At this inspection we found:

• Safety concerns were not consistently identified or addressed in a timely manner. Reviews and learning from incidents were not thorough.
• Information about services and how to complain was available but complaints were not used as an opportunity to learn and improve.
• Risks to patients were not always assessed and appropriately managed.
• Some audits had been carried out but there was no evidence that audits were driving improvements. Data showed patient outcomes were comparable with the local and national averages.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Staff were aware of current evidence based guidance and had been trained to provide them with the skills and knowledge to deliver effective care and treatment. However staff had not received annual appraisals.
• The practice offered 15 minute appointments 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.
• Some of the staff we spoke with said they felt supported by management but there was a lack of structured governance and leadership within the practice.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients
• Ensure there is an effective system for identifying, receiving, recording, handling and responding to complaints by patients and other persons in relation to the carrying on of the regulated activity
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

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 the practice of Dr Salam J Farhan on 5 February 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 with an effective system for reporting and recording significant events. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Learning from incidents and events was evidenced but systems were not robust enough to ensure learning was always achieved.
• Risks to patients were assessed and well managed.
• 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.
• 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 but negative comments by patients were not formally recorded and reviewed.
• Most 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. Some negative comments were reported about the appointment system.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Following an unsettled period resulting in major staff changes, there was now 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.

Areas where the practice should make improvements :

• Introduce a system to identify that communications have been received and learning has been achieved.

• Encourage staff to report negative comments from patients to analyse trends and assess whether further investigation is required.

• Introduce a formal process of regular documented clinical and other meetings.

• Increase staff knowledge on what to do to help patients in vulnerable circumstances, such as homeless, domestic violence, travellers and/or those with language difficulties, if they presented.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating 20/02/2018 Requires Improvement)

At the February 2018 inspection the key questions were rated as:

Are services safe? Requires Improvement

Are services effective? – Require Improvement

Are services caring? – Requires improvement

Are services responsive? – Requires improvement

Are services well-led? – Requires Improvement

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 comprehensive inspection at Dr Salam J Farhan, also known as Partington Central Surgery on 14 August 2018. This was a full comprehensive inspection carried out to check that the practice had made the required improvements.

At this inspection we found:

• Safety concerns were now consistently identified and addressed in a timely manner. Reviews and learning from incidents were now thorough and there was a clear system 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. It ensured that care and treatment was delivered according to evidence-based guidelines.
• There was evidence that audit was driving improvement and complaints were now used as an opportunity to learn and approve.
• Staff involved patients and treated them 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. Fifteen-minute appointments were provided to all patients.
• There was evidence of sustained improvement and a strong focus on continuous learning at all levels of the organisation.

The areas where the provider should continue to improve are:

• Improve the processes for uncollected prescriptions and checks on children who have missed hospital appointments to ensure they are failsafe.
• Refine the process around incident review, in particular about who is taking action.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice