Dr Joseph Arayomi

We carried out an announced focused inspection at Dr Joseph Arayomi on 11 February 2020 as part of our inspection programme. Prior to our inspection we undertook an annual regulatory review of the information available and made the decision that the overall quality of care had not changed. This inspection was completed to follow up on a previous breach of regulation in the key question of safe, to review the requires improvement rating of this key question and look at any areas where we advised the provider should make changes.

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.

At this inspection we found the provider to be good at providing safe care and treatment.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Policies for safeguarding were personalised to the practice and contained details identifying the safeguarding lead. Other policies were also personalised to the practice.
• Recruitment processes kept patients safe.
• There was a system in place to review the registration status of clinical staff.
• A record was kept of staff immunisations in line with current guidance.
• Prescription stationery was kept securely.
• Complaints and significant events were disseminated to relevant staff and learning discussed.
• There were systems in place to engage patients and carers in national screening programmes.
• Latest published data for patients with Chronic Obstructive Pulmonary Disease (COPD) shows that performance has improved.
• There was a business continuity plan in place, which was accessible and known to all staff.
• There was a vision and strategy which all staff were aware of and involved in.

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

We carried out an announced comprehensive inspection at Dr Joseph Arayomi on 15 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 good overall and good for all population groups.

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

• Recruitment processes were not consistent and did not always follow national guidance.
• Although there was a procedure for the security of prescription paper this was not always followed.
• The practice had significant events as a standing item on meeting agendas however minutes did not demonstrate that discussion and learning had occurred.

We rated the practice as good for providing effective, caring, responsive and well-led services because:

• The practice was aware of its performance and had identified where improvement was required. The practice had plans in place to effect these changes.
• There was evidence of improvements to the level of care and treatment experienced by patients. The practice was aware further progress was needed to sustain this.
• Feedback from patients about the care provided and the attitude of staff was positive.
• Patients found it easy to make appointment.
• The practice were aware of their patient population and worked to ensured that services provided reflected their needs.
• Leaders were visible and staff felt supported by them.
• There was evidence of good teamwork and a culture that made staff feel able to raise concerns and suggestions for improvement. Staff had confidence that these would be considered.

The areas where the provider must make improvements are:

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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

The areas where the provider should make improvements are:

• Review the business continuity plan, where copies are stored and make sure all staff are aware of it.
• Review the implementation of procedures around prescription paper security and ensure that all policies are personalised to the practice.
• Review the audit trail demonstrating learning and dissemination of complaints and significant events.
• Review processes for engaging patients and carers to improve uptake of childhood immunisations and screening rates for all types of cancer screening.
• Continue to improve outcomes for patients with Chronic Obstructure Airways Disease (COPD) and overall patient experience whilst in consultations.
• Ensure that staff are aware of and involved in the practice’s vision and strategy.

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