Dr Rana Chowdhury

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Rana Chowdhury on 11 January 2017. The overall rating for the practice was inadequate and the practice was placed in special measures for a period of six months. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for Dr Rana Chowdhury on our website at www.cqc.org.uk.

This inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 18 October 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. The practice learnt from significant events.
• There was no child safeguarding policy in place despite external contact details being available. However since the inspection, the practice has provided evidence of a new child safeguarding policy that has been implemented.
• Improvements had been made to the governance of the practice which had impacted on patient outcomes.
• Risks to patients who use the services were well managed.
• Patients said they were treated with compassion, dignity and respect, and they were involved in their care and decisions about their treatment.
• 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.
• Staff had knowledge of the practice vision and there was a business plan to support this vision and the practice strategy.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• To continue review how patients with caring responsibilities are identified and recorded on the patient record system to ensure information, advice and support is made available to all.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

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 Rana Chowdhury on 11 January 2017. Overall the practice is rated as inadequate.

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, reviews, investigations and learning was not always effective.
• Although risks to patients who used services were assessed, the systems and processes to address these risks were not in all instances implemented well enough to ensure patients were kept safe, specifically in relation to mandatory training, fire drills, portable appliance testing (PAT) and implementing recommendations from a recent legionella risk assessment.
• 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 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.

• 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 practice had a number of policies and procedures to govern activity, but there was no evidence to confirm that staff were following them.
• The practice did not have a mission statement and their staff had no knowledge of the practice vision.
• The practice did not have a business plan and had no strategy for the future.
• The governance arrangements at the practice were not effective.
• Not all staff were able to fully utilise clinical computer systems

The areas where the provider must make improvements are:

• Put a system in place to ensure mandatory training, in particular fire safety, safeguarding and infection control, is up-to-date.

• Establish risk assessments and procedures for the monitoring of high risk medicines, actions identified in the recent Legionella risk assessment must be acted on.

• Improve the monitoring of patients on high risk medicines.

• Investigate safety incidents thoroughly and ensure that the procedures are adhered to and there are effective reporting systems in place.

• Establish a system for disseminating and acting upon national patient safety alerts to ensure staff are aware of the process.Review what emergency drugs are kept and the system for ensuring they are fit for purpose.

In addition the provider should:

• Develop an ongoing programme of clinical audit and re-audit to ensure outcomes for patients are maintained and improved.

• Establish a system to monitor prescriptions that had not been collected.

• Review how patients with caring responsibilities are identified and record them on the clinical system to ensure information, advice and support is available to them.

• Ensure staff have the capability to utilise clinical computer systems.

On the basis of the ratings given to this practice at this inspection I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care we will take steps to cancel its registration with CQC.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice