Archived: Dr Navaid Alam Also known as TG Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Navaid Alam (TG Medical Centre) on 17 May 2016 and at this time the practice was rated overall as good. However breaches of legal requirements were also found. After the comprehensive inspection the practice wrote to us and told us that they would take action to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2010, Safe care and treatment.

Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2010, Safeguarding service users from abuse and improper treatment.

On 5 October 2016 we carried out a focused review of this service under section 60 of the Health and Social care Act 2008 as part of our regulatory functions. The review was carried out to check whether the provider had completed the improvements needed and identified during the comprehensive review in May 2016. This report only covers our findings in relation to those requirements. The report from our last comprehensive inspection can be read by selecting the ‘all reports’ link for Dr Navaid Alam on our website at cqc.org.uk

The findings of this review were as follows:

• The practice had addressed the issues identified during the previous inspection.

• Effective systems were now in place to safeguard people and prevent abuse. Staff had been suitably trained and policies and procedures reflected current guidance and legislation.

• Effective systems were now in place to monitor and mitigate the risks relating to the health, safety and welfare or patients and others. In particular in relation to the risks of general environmental risks, infection, storage of vaccines, medical equipment use and the management of prescription security.

We found that the practice had acted upon other recommendations made at the previous inspection to improve the service and care. For example:

• There was an effective system was in place to monitor clinical staffs professional registration such as with the General Medical Council (GMC) and Nursing and Midwifery Council (MNC).

• An audit policy and plan was in place.

• Patient reviews were undertaken and an effective system was in place to recall patients needing reviews.

• A nurse practitioner had been appointed which will increase capacity to care and treat patients.

• A NICE guidance policy had been implemented to set out the processes for implementing, monitoring and reporting progress in relation to NICE guidance and quality standards.

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 Navaid Alam (TG Medical) on 17 May 2016. Overall the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events.

• Safety alerts were received and acted upon, however there was no documented evidence to demonstrate this.

• Risks to patients were not well assessed.

• Safeguarding training was not undertaken by all staff at relevant levels to their role and safeguarding policies and procedures were out of dated and in need of revision.

• There were sufficient numbers of suitably qualified staff to meet the needs of patients.

• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.

• Premises and equipment were clean and secure however they were not always properly maintained.

• Infection control procedures were in place; however improvements were needed to some aspects of infection prevention and control.

• 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.
• Patients received explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• 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.
• Patients said that sometimes it was difficult to make an appointment with a named GP. Appointments generally ran to time and patients were given time to discuss their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients.

• Staff were supervised, felt involved and worked as a team.

• Governance arrangements were in place such as policies and procedures, audits and learning from incidents, events and complaints.

• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvements are:

• Ensure safeguarding policies and procedures reflect current guidance and legislation.

• Ensure staff are familiar with the policies and procedures, are trained and have a knowledge and understanding of safeguarding vulnerable adults and children.

• Ensure systems and processes are in place for assessing, monitoring and mitigating risks associated with general environmental risks (including control of substances hazardous to health (COSHH)), infections ( including those healthcare associated), storage of vaccines and risks of unsafe management of prescription pads.

• Ensure records relating to patients are stored safely in accordance with current legislation and guidance.

• Ensure the premises are safe by making sure electrical equipment is tested and maintained.

• Ensure medical equipment used is maintained properly.

In addition the provider should:

• Review the system for managing safety alerts and notices to include documenting action taken.

• Review and implement a system for monitoring clinical staff’s professional registration status such as with the Nursing and Midwifery Council (NMC) and the General Medical Council (GMC).
• Review the implementation of an audit programme for the practice to include prioritisation of audits according to local and national needs, legislation and guidance.
• Review the system of checking the medical emergency equipment to include documentation of such checks.
• Review the system for reviewing, implementation and dissemination of NICE guidelines.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice