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Dr Parvinder Garcha Good Also known as Hounslow Family Practice

Reports


Review carried out on 5 February 2020

During an annual regulatory review

We reviewed the information available to us about Dr Parvinder Garcha on 5 February 2020. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 11 September 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Parvinder Garcha, also known as Hounslow Family Practice, on 22 June 2016. The practice was rated as requires improvement for providing safe, effective, and well-led services, and good for providing caring and responsive services. Overall the practice was rated as requires improvement. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Dr Parvinder Garcha on our website at www.cqc.org.uk.

This inspection was an announced comprehensive follow up inspection on 11 September to check for improvements since our previous inspection. The practice is now rated as good for providing safe, effective, caring, responsive and well-led services. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • 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.
  • 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 evidence of kind and compassionate care, with the GP principal providing his direct contact number to palliative care patients and their families. The GP also visited these patients in hospital and liaised with hospital staff to ensure continuity of care was maintained.
  • 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.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients we spoke with said 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 the GPs and 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.

The areas where the provider should make improvement are:

  • Implement safety signage to indicate oxygen is stored on the premises.
  • Review the system to monitor and assess performance for the childhood immunisation programme.
  • Advertise that a translation service is available to patients on request.
  • Raise staff awareness of the practice’s updated complaints procedure.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 22 June 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Parvinder Garcha on 22 June 2016. Overall, the practice is rated as Requires Improvement.

Our key findings across all the areas we inspected were as follows:

  • Several

    Most of the systems and processes to address risks to patients were not implemented well enough to ensure patients were kept safe. For example, sharing of safety alerts, infection control, vaccines management, recruitment, health and fire safety, emergency medicines and basic life supporting training.

  • There was insufficient management capacity and a small amount of nursing provision which had an impact on monitoring safety at the practice. The practice had identified these as areas that needed to be strengthened. They also mentioned high staff turnover, information technology issues, financial insecurity and a high workload as developments areas.

  • The practice had a number of policies and procedures to govern activity; however, not all staff were aware of the duty of candour or whistleblowing policy.
  • Same day appointments were available but access to non-urgent appointments was not effective. The practice told us they had addressed this by adding in additional Saturday clinics when needed.

  • Staff understood their responsibilities to raise concerns, and to report incidents and near misses. There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Patients told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Improvements were made to the quality of care because of complaints and patient feedback. The practice had commenced the Productive General Practice Programme designed to help them deliver high quality care and respond to patient needs, whilst meeting increasing levels of demand.
  • There was no longer a patient participation group (PPG) set up in the practice however, patients had been nominated for the locality PPG. The practice strengthened efforts to set up a PPG in conjunction with the local Clinical Commissioning Group, and did so successfully after the inspection. 

  • The GP was the homeless lead for the locality and worked together with the outreach nurse and homeless charities.

We saw an area of outstanding practice:

  • The GP took the lead in coordinating end of life care and would visit patients while in hospital, including those out of the practice area, on a weekly basis to provide support to the patient and their family as well as to assist in complex discharge planning. For these patients the GP also delivered prescribed medicines for those unable to attend the pharmacy; stood in for carers when they were not available by assisting family members to undertake personal care tasks for an end of life patient. Arrangements had been made so that these patients could contact him directly during normal working hours and out of hours. We saw examples where the GP attended to ill patients in the early hours of the morning instead of the out of hours GP, to ensure they received continuity of care.

The areas where the provider must make improvements are:

  • Implement effective

    formal governance arrangements including systems for assessing and monitoring risks. This includes ensuring systems are in place to effectively monitor exception reporting, recruitment and staffing levels, mandatory staff and induction training as well as ensuring that that all staff are aware of the policies and procedures in place at the practice and up to date records are kept of practice meetings.Ensure staff undertaking vaccines fridges temperature monitoring are suitably trained and r

    eview policy and procedures for cold chain management and ensure all staff are aware of this.

  • Ensure care is and treatment is provided in a safe way for service users. This includes the timely dissemination of safety alerts to all staff, effective infection control procedures, fire and health and safety as well as medicines management for vaccines and emergency medicines within the service.

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

In addition the provider should:

  • Monitor and improve outcomes for patients in relation to areas of high exception reporting.

  • Review and improve the provision of non-urgent appointments to improve patient satisfaction.

  • Take steps to improve patient satisfaction with the care and treatment provided by the nursing staff.
  • Provide practice information in appropriate languages and formats and ensure notices informing patients of translation services are clearly displayed in the reception areas or television screen.Take reasonable steps to ensure a practice patient participation group (PPG) is

    establ

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Inspection carried out on 10 January 2014

During a routine inspection

During our visit to the practice we spoke with three people who use the service. They told us that they felt treated with respect by their GP, that they listened to them and they felt involved in their care and treatment. One person told us that �all the staff are lovely, and very friendly�. All the people we spoke with said that they felt they were given enough time during their appointment to be able to discuss their needs with the GP or practice nurse. They felt informed about different treatment options available to them and involved in decisions about their care.

We looked at the feedback forms that the practice asked people to complete, as well as the log of complaints received. We also saw the feedback people had put onto the NHS Choices website. This information helped us to gain an overview of people�s experiences of the service.

We spoke with the lead GP, a practice nurse, the practice manager, healthcare assistant and reception staff. They all said they enjoyed working at the practice, that there was good teamwork and they felt supported by the provider and the other staff.

There were systems in place to minimise the spread of infection and ensure that equipment was safe and appropriate for use.

Some systems were in place to monitor the quality of service provided, however, people's views and opinions had not always been taken into consideration in relation to how the service was run.