The Care Quality Commission
  • Doctor
  • GP practice

Dr Samir Sadik

Overall: Inadequate read more about inspection ratings

1 Dunkerley Street, Ashton Under Lyne, Lancashire, OL7 9EJ (0161) 330 7087

Provided and run by:
Dr Samir Sadik

All Inspections

31 May 2023

During an inspection looking at part of the service

We carried out an announced comprehensive at Dr Samir Sadik on 31 May 2023 Overall, the practice is rated as Inadequate.

Safe - Inadequate

Effective - Inadequate

Caring - Good

Responsive - Requires Improvement

Well-led - Inadequate

At the last inspection on 17 November 2022 the practice was rated good because we saw improvements after the practice was placed in special measures on 28 August 2019. At this inspection on 31 May 2023 we found many repeated concerns that had been raised in 2019 and the improvements that were previously implemented had not been embedded or continued.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr Samir Sadiq 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 about the operation of the service and in response to risk.

Key questions inspected

  • Safe
  • Effective
  • Caring
  • Responsive
  • Well Led

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 team meetings.
  • 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.
  • Reviewing feedback from staff questionnaires
  • Speaking to staff

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 rated the provider as inadequate for providing safe services. This was because :-

  • The provider did not offer care in a way that kept patients safe and protected them from avoidable harm.
  • Safeguarding was not given sufficient priority and satff were not suitably trained
  • Staff had not undertaking mandatory training
  • Risk assessments were not undertaken
  • The arrangements for managing medicines did not always keep people safe
  • Significant events were not discussed, shared and learned from
  • The provider did not assess, monitor and improve staff capacity to ensure it was sufficient and safe to meet the needs of the service

We rated the provider as inadequate for providing effective services. This was because :-

  • Patients did not always receive effective care and treatment that met their needs.
  • Care and treatment was not always delivered in line with current legislation, standards and evidence based guidance supported by clear pathways and tools.
  • Patients with long term conditions did not receive reviews that included all elements to sustain good outcomes.
  • Patients were not always followed up in a timely manner when necessary.
  • Quality improvement activity did not evidence improvement.

We rated the provider as good for providing caring services. This was because :-

  • Staff said they dealt with patients with kindness and respect and said they involved them in decisions about their care as much as possible. Feedback from the patient survey demonstrated improvement.

We rated the provider as requires improvement for providing responsive services. This was because :-

  • Patients could not always access care and treatment in a timely way.
  • Complaints were not managed in a way that demonstrated the duty of candour and were not always dealt with in accordance with regulatory requirements.

We rated the provider as inadequate for providing well led services. This was because :-

  • The way the practice was led and managed did not promote the delivery of high-quality, person-centre care.
  • The overall governance arrangements were not effective.
  • There was a lack of leadership at the practice.
  • Arrangements for identifying, recording and managing risks, issues and mitigating actions were not effective.
  • Structures, processes and systems for accountability were not clearly set out or understood by staff.

We found breaches of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
  • Send CQC a written report setting out what governance arrangements are in place and any plans to make improvements
  • Ensure there is an effective system for identifying, receiving, recording, handling and responding to complaints by patients and other persons in relation to the carrying on of the regulated activity

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration. Special measures will give people who use the service the reassurance that the care they get should improve.

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

17 November 2020

During an inspection looking at part of the service

We last inspected Dr Samir Sadik (also known as Waterloo Medical Centre) on 28 August 2019.

The practice was rated as good for being safe, caring, responsive and well-led, and requires improvement for being effective and population groups, people with long-term conditions, families, children and young people and working age people. This resulted in an overall rating of good.

We found that the provider had breached one regulation of the Health and Social Care Act 2008. We issued a Requirement Notice in relation Regulation 12 HSCA (RA) Regulations 2014 Safe care and Treatment. The report on this inspection can be found on our website at: https://www.cqc.org.uk

We carried out this focused desk-based review of Dr Samir Sadik on 17 November 2020. The purpose of this review was to determine if the services provided by the practice were now meeting the legal requirements and regulations under Section 60 of the Health and Social Care Act 2008.

We found that improvements had been made and the provider was no longer in breach of the regulations. The practice is now rated ‘good’ for providing an effective service.

During this desk-based review we interviewed staff over the telephone and looked at a range of documents submitted by the practice to demonstrate how they had met the requirements notice. Information reviewed included:

  • Practice action plan
  • Publicly available data, including data relating to treatment of patients with long term conditions, up-take of childhood immunisations and cervical screening.
  • Systems and process to monitoring patient outcomes and medicines prescribed.

During this desk-based review we looked at the following question:

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

  • There was a clear system in place to monitoring of the outcomes for patients with long term conditions and the Quality Outcomes Framework data 2019/20 showed significant improvement, with the practice now in line with local and national averages..
  • There was a clear governance system in place to continually monitor and audit data to ensure they continued to offer effective care.
  • A clear quality improvement plan was in place and additional nursing staff had been employed to improve up take of both childhood immunisations and cervical screening.

In addition, the practice have also updated the telephone system and launched a new website to improve access and communication with patients.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

28 August 2019

During a routine inspection

We carried out an announced comprehensive inspection at Dr Samir Sadik (also known as Waterloo Medical Centre) on 9 January 2019 as part of our inspection programme.

In January 2019 we rated this practice as inadequate overall and they were placed into special measures.

The domain ratings were:

Safe – Inadequate

Effective – Requires improvement

Caring – Good

Responsive – Good

Well-led – Inadequate

A warning notice was issued in respect of Regulation 17 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 (good governance). This stated improvement must be made by 30 April 2019.

We carried out a further focused inspection on 9 May 2019 to check the warning notices had been complied with. We found improvements in both these areas. These reports can be viewed by selecting the ‘all reports’ link for Dr Samir Sadik on our website at www.cqc.org.uk.

This inspection on 28 August 2019 was a full follow-up inspection to check the required improvements identified in January 2019 had been made throughout the practice.

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 have now rated this practice as good overall, with safe, caring, responsive and well led as good. We rated effective, patients with long term conditions and families, children and young people and working age people as requires improvement.

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs, however systems to ensure care and treatment for those with long term conditions was not robust.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
  • The practice had been working closely with the CCG and had sought support from the RCGP to assist them in making improvement across the practice following our previous inspection.

We rated the practice as requires for providing effective services because:

  • There was limited monitoring of the outcomes for patients with long term conditions.
  • Quality Outcomes Framework data was significantly below local and national averages for patients with long term conditions.

The areas where the provider must make improvements are:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Review data for Childhood immunisations and look to implement systems to achieve target
  • Review date related to cancer indicators and look to implement systems to improve screening up take.
  • Monitor quality improvement work to bring NASIDs prescribing in line with good practice.
  • Implement plans to develop a practice website.

As a result of the improvements made the practice has been re-rated and removed from special measures.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

09 May 2019

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Dr Samir Sadik (also known as Waterloo Medical Centre) on 9 January 2019 as part of our inspection programme.

We rated this practice as inadequate overall and they were placed into special measures.

The domain ratings were:

Safe – Inadequate

Effective – Requires improvement

Caring – Good

Responsive – Good

Well-led – Inadequate

A warning notice was issued in respect of Regulation 17 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 (good governance). This stated improvement must be made by 30 April 2019.

This inspection on 9 May 2019 was to check the requirements of the warning notice had been met. We found that improvements had been made.

In particular:

  • A programme of work was underway to establish clear system and process for the safe prescribing of high-risk medicines and to ensure patients were being appropriately monitored.
  • We saw that a programme of medicine and prescribing audits was in place. We saw evidence of improvement being made in relation to monitoring and reviewing patients prescribed high risk medicines.
  • A programme of work had been established to ensure health and safety systems were in place. Risk assessments had been carried out, however there were actions identified which still needed to be completed.
  • There was a system in place to oversee children on the safeguarding register.

The rating of inadequate awarded to the practice following our full comprehensive inspection on 9 January 2019 remains unchanged. The practice will be re-inspected, and their rating revised if appropriate in the future.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

09 Jan 2019

During a routine inspection

We carried out an announced comprehensive inspection at Dr Samir Sadik (AKA Waterloo Medical Centre) on 9 January 2019 as part of our inspection programme.

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 have rated this practice as inadequate overall. In relation to the population groups we have rated as requires improvement.

We found that:

  • The practice did not consistently provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients in the main received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
  • The practice was not well led and did not always have systems and process in place to monitor and mitigate risk.

We have rated this practice as inadequate overall.

We rated the practice as inadequate for providing safe services because:

  • The practice did not have clear systems and processes to keep patients safe.
  • The practice did not have appropriate systems in place for the safe management of medicines.
  • The practice did not have systems and process in place to assess the risk associated with health and safety or fire safety within the practice.

We rated the practice as requires improvement for providing effective services because:

  • There was limited monitoring of the outcomes of care and treatment.
  • The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.

We rated the practice as inadequate for providing well-led services because:

  • The overall governance arrangements were ineffective.
  • The practice did not have clear and effective processes for managing risks, issues and performance.

We rated the practice as good for providing caring and responsive services because:

  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • Ensure there is a formal record of the actions taken in response to safety alerts.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Following the inspection, we were provided with details of actions the provider has initiated to address the concerns identified within the report.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

19/10/2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Samir Sadik on 10 February 2016. The overall rating for the practice was good, with one area, safe rated as requires improvement. The full comprehensive report on the February 2016 inspection can be found by selecting the ‘all reports’ link for Dr Samir Sadik on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 19 October 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 10 February 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as Good and the practice is now rated good for being ‘safe’.

Our key findings were as follows:

  • Recruitment records relating to people employed now include information relevant to their employment such as photo identification and DBS checks in line with legal requirements.

We also noted the practice had made additional improvement which included:

  • We saw the practice had an up to date business continuity plan in place.
  • Additional nursing staff had been recruited and the practice had the flexibility to add additional nursing sessions when required.
  • A new recall system has been introduced to ensure patients have access to annual reviews in a timely manner.
  • We saw an audit cycle had been initiated by the lead GP.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

10/02/2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Samir Sadiks’ on 10 February 2016. Overall the practice is rated as good.

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • Risks to patients were assessed and well managed.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • Data showed patient outcomes were comparable to those locally and nationally.
  • Feedback from patients about their care was consistently and strongly positive.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Patients said they found it easy to make an appointment and that there was continuity of care, with urgent appointments available the same day.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
  • Information about services and how to complain was available and easy to understand.
  • 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 sought feedback from staff and patients, which it acted on.

However there were areas of practice where the provider must make improvements:

  • Ensure recruitment and selection processes are in place in line with legal requirements.

In addition the provider should:

  • Have a formalised business continuity plan in place
  • Look to establish a full cycle audit programme in addition to those initiated by the CCG.
  • Ensure sufficient levels of nursing staff are in post.
  • Ensure an adequate recall system is implemented to ensure patients who require anuual reviews, receive them in a timely manner.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

12 June 2013

During a routine inspection

We found a bright, airy, clean practice with ample seating for patients. We found there was parking at the front of the practice. The practice was all on one level and there was appropriate disabled access to the service.

We spoke with two patients on the day. Patients spoke positively about the practice and commented that they were happy with the care they received.

The practice provided patients with information about the services available through leaflets displayed throughout the practice.

The practice had electronic patient records in place to record the contact patients had with the service but also had the historic records in paper base stored for reference if required.

We found staff had access to contact details for both child protection and adult safeguarding teams. They were able to describe the appropriate actions to take if they had any safeguarding concerns.

The practice had a range of policies and procedures in place for staff to access, which supported the safe running of the service. We found the practice had an audit programme ongoing and the results were fed back at practice meetings on a monthly basis.

The practice leaflet provided patents with information about how to raise a concern or complaint. Patients we spoke with told us they would raise any concerns with the clinical or reception staff and felt they would be appropriately dealt with in a swift manner.