During an assessment under our new approach
Date of Assessment: 9 July 2025 to 10 July 2025. Dr Abdul Naeem also known as Dog Kennel Lane surgery is a GP practice and delivers services to 2192 patients under a contract held with NHS England. The National General Practice Profiles states that 51.23% of patients are White, 30.86% Asian, 8.52% Black, 5% Mixed and 4.39% Other. Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 2nd decile (1 of 10). The lower the decile, the more deprived the practice population is relative to others. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.
SAFE: The service had recently implemented processes for the recording of incidents and significant events; however, we found no evidence to demonstrate that there was an effective learning culture. Staff understood and managed risks. People were protected and kept safe. The facilities and equipment met the needs of people, were clean and well-maintained, but systems for monitoring vaccines required improvement. We found there were staff with the right skills, qualifications and experience, but feedback highlighted staff were not provided with time to complete training deemed mandatory by the provider. Staff managed the majority of medicines well; however, we found further improvements were needed in the management of long-term conditions and medicines that required regular monitoring to ensure people received the appropriate reviews and care.
EFFECTIVE: People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice; however, we found evidence based guidance was not always followed. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those important to people took decisions in people’s best interests where they did not have capacity.
CARING: People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and treatment. The service supported staff wellbeing.
RESPONSIVE: People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.
WELL LED: Leaders and staff had a shared vision and culture based on listening and trust. However, we found governance processes required strengthening to ensure all risks were mitigated. We identified gaps in staff training and no effective processes in place to ensure this was monitored on a regular basis. Leaders were visible, knowledgeable and supportive. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas.
We found breaches of regulation in relation to:
Regulation 12 Safe Care and Treatment and Regulation 17 Good Governance. We have asked the provider for an action plan in response to the concerns found at this assessment.