This practice is rated as Good overall. (Previous inspection August 2017 – Good)

The key questions 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 focused inspection at Dr Samy Morcos on the 27 September 2018. This was to follow up on a breach of regulations identified at our previous inspection. At our previous inspection on the 24 August 2017 we found that the provider did not have complete records of recruitment. The details of these can be found by selecting the ‘all reports’ link for Dr Samy Morcos on our website at www.cqc.org.uk.

At this inspection we found:

• The practice had addressed the concerns that were identified at our previous inspections and had complete records of recruitment checks.
• The practice had processes in place to report concerns or actions and monitor the actions taken by the landlord regarding property maintenance.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

When we visited Dr Samy Morcos (which is also known as The White Practice) on 15 November 2016, to carry out a comprehensive inspection, we rated them as good overall. However, we found breaches in the regulations relating to employment of staff and rated the practice as required improvement for the provision of safe services. We said that they must:

• Ensure the staff records required by regulation are in place and maintained on record.

We also said they should;

• Keep their national patient survey results under review and take action as appropriate. This included reviewing the low response levels related to involvement in decisions about care.

This inspection was an announced focused inspection carried out on 24 August 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified at our previous inspection. This report covers our findings in relation to those requirements. This report should be read in conjunction with the full report of our inspection on 15 November 2016, which can be found on our website at

www.cqc.org.uk

.

We found the practice had not done enough to meet the regulation previously breached and the practice continues to be rated as requires improvement for the provision of safe services. Overall the practice continues to be rated as good.

Our key findings were as follows:

• The practice had not ensured that the staff records required by regulation were in place and maintained on record. Specifically,

  • Not all the references for staff were in writing and included the referee’s name, job title and a landline number as recommended by best practice guidance.

  • The practice did not have adequate process in place to assure themselves that  nurses employed at the practice continued to be on the professional nurse register.  

• We found there were some on-going issues regarding the safety of the building. For example, there was no evidence the actions recommended by a specialist contractor in December 2016 in relation to the risks posed by asbestos had been completed.​

• We saw evidence that the practice had been reviewing their results from the national GP patient survey.

   The latest survey results published in July 2017 showed that 79% of patients said the last GP they saw was good at involving them in decisions about their care compared to the local average of 83% and national average of 82%. This was a 13% improvement from the previous year’s results.

We identified regulations that were not being met and the provider must:

• Ensure the staff records required by regulation are in place and maintained on record.

In addition the provider should:

• Continue to take action to ensure the actions recommended by an external specialist in relation to asbestos are completed.

• Ensure they adequately record actions taken to report building maintenance issues to the landlord.

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 Samy Morcos on 15 November 2016. Overall the practice is rated as Good.

Our key findings across all the areas we inspected 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.
• 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.
• 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. However the recruitment records for staff did not ensure patient safety.
• 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.
• Patients said they found it easy to make an appointment with a named GP 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.
• 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 provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• The provider must ensure records for staff required by regulation are in place and maintained on record.

The areas where the provider should make improvement are:

• The provider should keep their national patient survey results under review and take action as appropriate. This includes reviewing the low response levels related to involvement in decisions about care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection on 3 October 2013 we identified some concerns in relation to the cleanliness of the communal areas and some of the toilets. We were told that these areas were managed by the landlord. The provider had already identified concerns and we saw that there was regular correspondence from the provider to the landlord in relation to these areas. However, at the time of the inspection the provider had not been able to resolve these issues with the landlord. We asked the provider to take action and tell us how they would address these issues.

We followed this up with an inspection on 25 November 2013 and found that the cleanliness of the communal areas had improved and plans were in place to upgrade the toilets.

We were told that Dr Morcos had recently taken over the White Practice. Another practice in the same health centre had recently closed, and the White Practice had taken on additional patients as a result of the closure.

During our inspection we saw that staff treated patients with respect. Patients told us “Staff are very helpful”.

Patients told us that they felt well informed during their consultations and that they were able to make informed decisions about their treatment. One patient told us “They discussed options with me and then I decided what to do”. Patients commented positively on their care. For example, one patient told us “I had to be referred for a scan and it was fast and efficient”.

Patients told us they felt safe at the White Practice and when asked one patient told us “Yes, always”.

We saw that the areas of the building within the control of the White Practice were reasonably clean and tidy. However, the communal areas managed by the landlord were dusty and shabby and the toilets were not furbished to a standard to ensure hygienic cleanliness. We noted that other communal areas were in need of repair and redecoration.

We saw that staff had received training and appraisals and staff confirmed that they felt well supported.

There was an effective complaints procedure in place and complaints were responded to appropriately.