Lowmoor Road Surgery Also known as Drs Barish & Balakrishnan

Updated 10 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lowmoor Road Surgery on 8 August 2016. Overall the practice is rated as good.

• There was an effective system in place for reporting and recording clinical significant events however non clinical events were not recorded.

• Lessons learnt were recorded as a result of incidents and discussed at practice meetings.

• The practice was visibly clean, however there was no schedule of completed cleaning available on the day of inspection.

• 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.

• Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

• We observed staff members were courteous and very helpful to patients and treated them with dignity and respect.

• Feedback from residential homes was positive and staff at the care homes said that the practice were responsive and always attended when required.

• The practice offered extended hours on a Saturday for working patients who could not attend during normal opening hours.

• Lessons were learnt from complaints and discussed with staff however information on how to complain was not readily available.

• There was a leadership structure in place. Staff told us they felt supported by management.

• The practice had a governance framework which supported the delivery of the strategy and quality care. However, we found some of the policies needed updating to reflect recent staff changes

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

• The practice encouraged and valued feedback from patients, the public and staff.

• There was a focus on continuous learning and improvement at all levels.

• Monitoring of some long term conditions and excepting those that were not eligible needed attention.

• The practice worked in collaboration with eight local practices (also referred to as JAKS federation) to improve access for patients with a weekly walk in service for patients on Wednesday (6.30pm to 8pm) and Saturday (9am and 12pm). This service was accessible to all patients registered with the eight local practices.

The areas where the provider must make improvement are:

• Ensure that there are appropriate systems in place to properly assess and mitigate against risks including risks associated with fire and managing emergency situations.

• Ensure a risk assessment is carried out and rationale documented for not ensuring a DBS check is in place for non-clinical members of staff.

• Ensure recruitment arrangements include all necessary employment checks for all staff

• Ensure patients’ medical records are stored securely at all times.

• Ensure the registration of the practice is updated to include all regulated activities.

The areas where the provider should make improvement are:

• Review performance and monitoring of long term conditions.

• Improve the identification of carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 March 2017

Updated 27 September 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.

• Immunisation rates were relatively high for all standard childhood immunisations.

• The practice’s uptake for the cervical screening programme was 79%, which was comparable to the CCG average of 79% and the national average of 74%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• Same day appointments were available for children who needed an urgent appointment.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 27 September 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• All patients over 75 years of age had a named GP for continuity of care.

• The practice met with other services such as district nurse, respiratory nurse and palliative nurse regularly to identify patients who are at high risk.

• Patients are reviewed in practice however home visits could be made were patients are housebound or in residential care.

Updated 27 September 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• Appointments were available on a Saturday morning and there was the option of attending a walk in service on a Wednesday evening or Saturday morning.

• Telephone appointments were available.

• The practice offered a full range of health promotion and screening that reflects the needs for this age group.

Updated 27 September 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• Performance dementia related indicators was 87% which was lower than the CCG average of 91% and the national average of 95%.

• Performance for mental health related indicators was 100% which was better than the CCG average of 91% and the national average of 93%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice provided emergency same day appointments for patients with mental health problems.

• The practice maintained a register of patients with mental health problems and provided annual reviews and medication reviews.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 27 September 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

• There was a lead GP for patients with drug and alcohol problems.