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Dr Maassarani and Partners Good

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 20 February 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection February 2015 – Requires Improvement)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Outstanding

People experiencing poor mental health (including people with dementia) - Outstanding

We carried out an announced comprehensive inspection at Dr Maassarani and Partners on 10 January 2018. Overall the practice is rated as good.

Previously we carried out an announced comprehensive inspection at Dr Maassarani and Partners on 03 February 2015. The overall rating for the practice was requires improvement. The practice was required improvement for safe and well-led services. Requirement notices were made as improvements were needed in the pre recruitment checks completed by the provider and quality of staff supervision and training. The full comprehensive report on the February 2015 inspection can be found by selecting the ‘all reports’ link for Dr Maassarani and Partners on our website at www.cqc.org.uk.

At this inspection we found:

  • Systems in place to ensure staff recruitment was safe were established.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
  • The practice had clearly defined and embedded systems to minimise risks to patient safety.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • In response to the GP survey results the provider had put systems in place to review and monitor their processes in areas with a lower than average satisfaction rate.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • In the 2017 GP survey patients said they did not always get to see the GP of their choice, however patients we spoke with and who completed CQC comment cards told us 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.
  • 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 provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

We saw areas of outstanding practice:

  • The practice was outstanding in the area of responsiveness to people in vulnerable circumstances. The practice accepted vulnerable migrants and had taken steps to employ staff from the migrant groups. Their role was to provide outreach into these communities to encourage a take up of health, social support and educational services.

  • The practice recognised the impact of long term debt and unemployment on mental and general health and worked with a local charity to provide job opportunities for young unemployed people and also a debt management service which had directly benefited their patients.

  • The systems and processes in place for enabling patients experiencing poor mental health to engage with the practice and receive care, treatment and support were outstanding.

The areas where the provider should make improvements are:

  • The provider should review their processes for identifying and documenting themes from complaints and incidents.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 20 February 2018

Effective

Good

Updated 20 February 2018

Caring

Good

Updated 20 February 2018

Responsive

Outstanding

Updated 20 February 2018

Well-led

Good

Updated 20 February 2018

Checks on specific services

People with long term conditions

Requires improvement

Updated 14 May 2015

There were aspects of the practice which required improvement that would have an impact on all of the population groups. Consequently the practice is rated as requires improvement for the quality of care provided to patients with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. Care plans were developed for these patients to prevent hospital admission. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. This included consultant led reviews from local Trusts to optimise management and increase the knowledge of practice staff.

Families, children and young people

Requires improvement

Updated 14 May 2015

There were aspects of the practice which required improvement that would have an impact on all of the population groups. Consequently the practice is rated as requires improvement for the quality of care provided to families, children and young people. There were systems in place to identify and follow up children living in disadvantaged circumstances and for those who were at risk, for example, children and young people who had a high number of A&E attendances. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses. Antenatal and post natal clinics were held at the practice. The practice had worked towards and achieved the Breast Feeding Welcome certificate. This involved work on ensuring the practice environment was ‘friendly’ towards breast feeding mothers, and staff being trained and having a level of awareness of the needs of breast feeding mothers and their babies.

The practice had good links with 'THinK', a Teenage Health Service for young people aged 13-19 that offered advice and treatment around contraception, STI screening, pregnancy testing, smoking cessation, drugs and alcohol.

Older people

Requires improvement

Updated 14 May 2015

There were aspects of the practice which required improvement that would have an impact on all of the population groups. Consequently the practice is rated as requires improvement for the quality of care provided to older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, they had good links with the local Falls Prevention Team so that patients at risk can be referred to this service for on-going assessment and support. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with more complex needs.

Working age people (including those recently retired and students)

Requires improvement

Updated 14 May 2015

There were aspects of the practice which required improvement that would have an impact on all of the population groups. Consequently the practice is rated as requires improvement for the quality of care provided to 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. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

The practice provided extended hours in the evening to accommodate those patients who worked in the daytime. Patients between the ages of 40 and 74 were systematically invited into the practice for a health check to discuss lifestyle and the prevention of heart disease and stroke.

People experiencing poor mental health (including people with dementia)

Requires improvement

Updated 14 May 2015

There were aspects of the practice which required improvement that would have an impact on all of the population groups. Consequently the practice is rated as requires improvement for the quality of care provided to patients experiencing poor mental health (including people with dementia). They had a risk stratification and case finding tool to identify high risk patients who may benefit from dementia screening and referral to memory clinics. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice had a psychological therapist working there each week offering talking therapies to patients over 16 years with a range of mild to moderate mental health problems. The practice also worked closely with the local community mental health team.

People whose circumstances may make them vulnerable

Requires improvement

Updated 14 May 2015

There were aspects of the practice which required improvement that would have an impact on all of the population groups. Consequently the practice is rated as requires improvement for the quality of care provided to patients whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability. They had carried out annual health checks for p patients with a learning disability and offered these and other vulnerable patients longer appointments with a GP to ensure their health needs were met.

The practice was working towards achieving the ‘Supporting Carers’ certificate which involved them developing and implementing a plan to identify ‘new’ carers, support known carers and ensure that patients know about services available to them. The practice worked in partnership with CRI Knowsley, a social care and health charity working with individuals, families and communities that were affected by drugs, alcohol, crime, homelessness, domestic abuse and antisocial behaviour. The practice held an multi-disciplinary team (MDT) meeting every three months which included a GP, the patient and the patients’ care worker to review progress and set goals and plans. As part of the PMS contract the practice engaged the Knowsley Domestic Violence service to help in identifying and supporting a ‘hard to reach’ population. The GP lead increased their knowledge and awareness around the local services available and referral options which led to an increased number of women being referred for support.