4 October 2023
During a routine inspection
We carried out an announced comprehensive inspection) at Dr Sahota's Practice (The Medical Centre) on 4 October 2023. Overall, the practice is rated as requires improvement.
Safe - requires improvement.
Effective – requires improvement.
Caring - requires improvement.
Responsive - requires improvement.
Well-led - requires improvement.
Following our previous inspection on 8 September 2016, the practice was rated good overall and for all key questions.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr Sahota's Practice (The Medical Centre) on our website at www.cqc.org.uk
Why we carried out this inspection
We carried out this inspection in response to concerns reported to us. We reviewed all key questions as part of this inspection.
How we carried out the inspection
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.
This included:
- Conducting staff interviews using video conferencing.
- Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
- A short site visit.
Our findings
We based our judgement of the quality of care at this service 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 found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm. However, we identified shortfalls in the processes for medicines monitoring and acting on safety alerts.
- Most patients received effective care and treatment that met their needs. However, we identified that patients with hypothyroidism were not always reviewed to ensure their treatment was optimised in line with national guidance and some patients did not always receive medicine reviews in line with national guidance.
- Feedback from patients was mixed about the way staff treated people. Data from the National GP Patient Survey (2023) showed that the practice was rated below local and national averages for most questions relating to interactions with healthcare professionals
- Data from the National GP Patient Survey (2023) showed that the practice was rated below local and national averages for most questions relating to accessing the service. Although we saw the practice was attempting to improve access, this was not yet reflected in the GP patient survey data or other sources of patient feedback.
- There were clear responsibilities, roles and systems of accountability to support good governance and management. However, improvements to some systems and processes were needed.
We found a breach of regulations. The provider must:
- Ensure care and treatment is provided in a safe way to patients.
In addition, the provider should:
- Continue to address all outstanding actions from the recent health and safety risk assessment.
- Improve the system for recruitment checks.
- Continue to improve the systems and processes to increase childhood immunisations and cervical screening uptake.
- Continue to seek and act on feedback from patients and staff.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Health Care