Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Saramma Samuel on 15 December 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 and a system in place for reporting and recording significant events.

• The practice had clearly defined systems in place to minimise risks to patient safety, with the exception of systems in place for safely prescribing and monitoring a high risk medicine called Methotrexate. (Shortly after our inspection we were sent confirming evidence that appropriate systems were in place to maintain patient safety regarding methotrexate prescribing).

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.

• People had good outcomes because they received effective care and treatment that met their needs. We also saw evidence that action had been taken to improve disease prevalence and ensure that patients were being identified and treated.

• 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.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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 practice was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

We saw one area of outstanding practice:

• The practice participated in a diabetes self-management programme which provided patients with education and lifestyle advice and enabled them to make informed decisions about their care and treatment. A recent audit highlighted that by the end of the programme, all 18 participants had reduced their blood sugar levels.

The areas where the provider should make improvement are:

• Continue to monitor systems introduced in relation to high risk medicines prescribing.

• Introduce a system to monitor the use of blank prescription forms.

• Monitor the impact of the practice nurse’s increased hours on cervical screening and child immunisation uptake.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Saramma Samuel on 26 March 2019 as part of our inspection programme.

At the last inspection in December 2016 we rated the practice as requires improvement for providing safe services because there were ineffective systems in place for prescribing the high-risk medicine methotrexate.

At this inspection, we found that the provider had satisfactorily addressed this area. We reviewed the prescribing of high-risk medicines and found there were safe and effective systems in place including a comprehensive policy which included the most up to date national guidance.

We based our judgement of the quality of care at this service is on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

We rated the practice as good for providing safe services because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• There were systems in place to protect vulnerable patients and staff we spoke to were able to demonstrate their knowledge of using these systems.

We rated the practice as good for providing effective services because:

• Patients received effective care and treatment that met their needs.
• The practice was able to demonstrate they analysed their performance and implemented plans to make improvements.

We rated the practice as good for providing caring services because:

• Feedback from patients was consistently positive and was in line with local and national averages.
• We observed staff interacting with patients in a caring manner.

We rated the practice as good for providing responsive services because:

• Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.
• Patient feedback was above local and national averages for accessing the service.

We rated the practice as good for providing well-led services because:

• The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.
• There was evidence that continuous learning and improvement were embedded in the culture of the practice.

These outstanding areas benefitted all population groups and so we rated all population groups as good.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care