Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Milman Road Surgery- Dr Mittal on 26 January 2016. The overall rating for the practice was good. The full comprehensive report on the January 2016 inspection can be found by selecting the ‘all reports’ link for Milman Road Surgery – Dr Mittal on our website at www.cqc.org.uk.

The practice registered an additional 5000 patients on 1 April 2017 following the closure of another practice in the same building. The practice that closed had a breach of regulation identified during their inspection in September 2016. CQC had also received information of concern regarding Milman Road Surgery – Dr Mittal that required follow up.

This inspection was an announced focused inspection, carried out on 23 May 2017, to follow up the issues of concern and verify that the practice systems in place supported the rapid increase in registered patients. This report covers our findings in relation to these issues and the information of concern we had received. We have not reviewed the existing ratings following this inspection.

Our key findings were as follows:

• The practice provided information in languages other than English to support patients whose first language was not English.
• Clinical audit was undertaken to improve outcomes for patients and an audit plan was in place.
• There was a system in place to manage requests for home visits and telephone consultations.
• The practice demonstrated an effective process for dealing with repeat prescription requests and issue of urgent prescriptions.
• There was a system in place to record and take action upon medicine and product alerts. Minutes of meetings showed that these were discussed and actions taken when appropriate. The GP we spoke with identified medicine alerts and the action taken when they were relevant to the practice.
• There was a portable hearing loop available for use at both reception desks to assist patients that used hearing aids.
• Automated doors were provided and a lift was available to assist patients with mobility problems.

The practice had systems in place that complied with regulations and supported the care of all registered patients. These systems addressed the breaches that had affected the practice whose patients transferred upon closure of the next door practice on 31 March 2017. The practice also demonstrated systems were in place to address the concerns CQC had received since the last inspection.

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 Milman Road Surgery – Dr Mittal on 26 January 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 an effective system in place for reporting and recording significant events.
• 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.
• The majority of patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. However, not all felt cared for, supported and listened to.
• Information about services and how to complain was available and easy to understand.
• There was minimal information about the translation services available.
• 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 had proactively sought feedback from patients and had a virtual patient participation group.
• The practice was aware of and complied with the requirements of the Duty of Candour.

However, the practice should:

• Ensure documents pertaining to the checking of emergency equipment are implemented and safely stored.

• Encourage active participation with the Patient Participation Group.

• Review the process for identifying carers to ensure they receive the appropriate care and support. Update the carer’s register accordingly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We looked at eleven patient treatment records and spoke with three patients who use the service. One patient told us, “this is a family practice; I get given the best treatment.” Records we reviewed showed care and treatment was planned to meet people’s needs.

Patients were protected from the risk of abuse as staff were able to identify and report any areas of concern. We saw the practices' safeguarding policy which detailed the process staff should follow if a safeguarding concern was raised.

We spoke with three doctors, two reception staff, one nurse and the practice manager. Staff told us they were happy working for the practice and felt supported in their roles. We saw evidence that staff employed by the practice had appropriate training.

There was an effective complaints system available and comments and complaints people made were responded to appropriately.