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Inspection Summary


Overall summary & rating

Good

Updated 12 June 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Dr Parvin Jalota on 4 May 2016. The overall rating for the practice was good with requires improvement in providing safe services. The full comprehensive report on the 4 May 2016 inspection can be found by selecting the ‘all reports’ link for Dr Parvin Jalota on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 16 May 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 4 May 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.

Our key findings were as follows:

  • Appropriate recruitment checks had been completed on employees.
  • Discussions held with the health visitor were recorded and a log sheet kept of each meeting included a record of when no issues had been raised.
  • The chaperone policy had been updated to include the position where a chaperone should stand.
  • Appropriate emergency medicines were available at the practice to treat possible complications associated with hypoglycaemia (low blood sugar) and suspected myocardial infarction (heart attack).

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

  • Ensure that all recruitment checks are carried out on locum GPs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 12 June 2017

  • Appropriate recruitment checks had been completed on employees. However there were some gaps in the checks carried out on a locum GP.
  • There was a system in place to record discussions with the health visitor and monitor the recording of these on the patients’ notes.
  • The chaperone policy had been updated to include an instruction on where a chaperone should be positioned.
  • Appropriate emergency medicines were available at the practice to treat possible complications associated with hypoglycaemia (low blood sugar) and suspected myocardial infarction (heart attack).

Effective

Good

Updated 12 June 2017

Caring

Good

Updated 12 June 2017

Responsive

Good

Updated 12 June 2017

Well-led

Good

Updated 12 June 2017

Checks on specific services

People with long term conditions

Good

Updated 27 May 2016

The practice is rated as good for the care of people with long-term conditions.

  • The GP and the nursing team were involved in chronic disease management and patients at risk of hospital admission were identified as a priority.
  • The practice maintained registers of patients with long term conditions. Patients were offered a structured annual review to check their health and medicines needs were being met.
  • Performance diabetes related indicators were comparable to the national average. The percentage of patients with diabetes, on the register, in whom a specific blood test was recorded was 84% compared with the national average of 78%.
  • Longer appointments and home visits were available when needed.
  • For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 27 May 2016

The practice is rated as good for the care of families, children and young people.

  • There were systems in place to identify and follow up children who were at risk, for example families with children in need or on children protection plans.
  • Appointments were available outside of school hours and the premises were suitable for children and babies. Same day emergency appointments were available for children.
  • There were screening and vaccination programmes in place and the practice’s immunisation rates
  • Data from the Quality and Outcomes Framework (QOF) for 2014/2015 showed that 81% of women aged 25-64 had received a cervical screening test in the preceding five years. This was comparable to the national average of 82%.
  • The practice offered a range of family planning and routine contraception services, although did not offer implant/coil fitting.
  • We saw positive examples of joint working with midwifes and health visitors. Midwife clinics were held at the practice. Although the GP discussed any concerns they had about children or families with them, they did not record these in the electronic patient records.

Older people

Good

Updated 27 May 2016

The practice is rated as good for the care of older people.

  • The practice offered proactive, personalised care to meet the needs of the older people in its population.
  • The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
  • The practice worked closely with the multidisciplinary team to reduce the number of unplanned admissions.

Working age people (including those recently retired and students)

Good

Updated 27 May 2016

The practice is rated as good for the care of 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 offered on the day and pre-bookable appointments, as well as telephone consultation. The practice also offered extended hours two evenings and one morning a week.
  • 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.

People experiencing poor mental health (including people with dementia)

Good

Updated 27 May 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

  • One hundred percent of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was above the national average of 84%.

  • Performance for mental health related indicators was comparable to the CCG and national average. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record was 100% when compared with the national average of 88%.
  • The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

People whose circumstances may make them vulnerable

Good

Updated 27 May 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

  • The practice held a register of patients living in vulnerable circumstances including families from the travelling community and those with a learning disability.
  • The practice offered longer appointments for patients with a learning disability.
  • The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
  • The staff knew how to recognise signs of abuse in vulnerable adults and children. The staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.