This practice is rated as Good overall. (Previous inspection 4 July 2017 – Good overall but Requires Improvement in the key question Effective)

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 a focused inspection at Dr M Ullah on 26 April 2018. This was to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our key findings at this inspection were as follows:

• We spoke with staff and reviewed a range of documents which demonstrated they were now meeting the requirements of Regulation 12 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014: Safe Care and Treatment.
• Timely care planning took place to ensure the health, safety and welfare of those service users, in particular for vulnerable patients.
• The practice had improved communications across the practice with the introduction of regular minuted meetings.
• The practice now had an up to date training matrix and plan for all staff.
• There was a system in place to continue to identify and support carers.

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 follow up comprehensive inspection at Dr Ullah on 4 July 2017.

The practice had been previously inspected on 12 August 2016. Following this inspection the practice was rated requires improvement in the following domain ratings:

Safe – Requires improvement

Effective – Requires improvement

Caring – Good

Responsive – Good

Well-led – Requires improvement

The practice provided us with an action plan detailing how they were going to make the required improvements.Overall the practice is now rated as good.

Our key findings from the most recent inspection were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Patients care plans were not in place for all vulnerable patients to meet individual patient needs and preferences.
• The practice had systems to minimise risks to patient safety. For example, a new process for hospital discharge amendments had been introduced.
• 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.
• 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.
• 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.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Review communication channels at all levels within the practice.
• Maintain an up to date training log for all staff.
• Continue to identify and support patients who are also carers

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 Ullah on 12 August 2016. Overall the practice is rated as requires improvement.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses, however there was a need to ensure that any shared learning outcomes were formally documented in order to monitor any improvement.
• Clinical audits had been carried out with evidence that audits were driving quality improvement, but no two cycle audits had been completed.
• No clinical checks were taking place for the repeat prescriptions reauthorisation process, with reception staff overriding the clinical system.
• Staff were adding, amending or removing hospital discharge medicines with no clear clinical checks in place.
• Patients care plans were in place but not patient specific to be able to meet individual needs and preferences.
• Not all staff had received regular training such as infection control; however there was access to online training available for all staff.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The provider was aware of and complied with the requirements of the duty of candour.

The area where the provider must make improvements are:

• To ensure all potential risks relating to medicine management and repeat prescribing are clinically assessed and managed appropriately.
• Ensure that patient care plans are in place and that they are reviewed and updated on a regular basis.
• Ensure that all staff receive appropriate training including Infection control.

The areas where the provider should make improvements are:

• Develop a quality improvement system to include full cycle audits.
• Develop systems to share learning with improvements documented.
• Develop practice vison and values.
• Develop a process to document serial numbers of prescription pads.
• Proactively identify carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice