The Care Quality Commission
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  • GP practice

Archived: Dr Arun Tangri Also known as Riverlyn Medical Centre

Overall: Requires improvement read more about inspection ratings

Station Road, Bulwell, Nottingham, Nottinghamshire, NG6 9AA (0115) 975 2666

Provided and run by:
Dr Arun Tangri

Important: The provider of this service changed. See new profile

All Inspections

04/01/2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection of Dr Arun Tangri on 4 January 2017. This inspection was undertaken to follow up on a warning notice we issued to the provider in respect of ensuring effective systems to enable the provider to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk. This included systems to ensure fire safety, the management of staff training, responding to complaints and making sure staff were safely recruited.

The practice received an overall rating of requires improvement at our inspection on 1 August 2016 and this will remain unchanged until we undertake a further full comprehensive inspection within six months of the publication date of the initial report.

You can read the report from our last comprehensive inspection, on our website at www.cqc.org.uk .

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

  • The practice had complied with the warning notice we issued and had taken the action needed to comply with legal requirements.

  • Significant improvements had been achieved in addressing the fire safety concerns identified at the comprehensive inspection on 1 August 2016. The practice had received advice from the local fire service who had assisted them in undertaking comprehensive risk assessments. An effective fire policy had been developed showing improvements made.

  • Infection control arrangements were reviewed to ensure roles were clear and to confirm who was responsible for making sure actions were completed.

  • Effective systems had been put in place to carry out recruitment checks making sure staff were suitable to work with patients.

  • Staff training had been reviewed and an effective system was put in place to support the development of staff.

  • An effective system had been implemented to manage complaints and significant events and analyse trends.

  • The practice sought feedback from patients on appointments for the purposes of continually evaluating and improving such services. Results were shared with patients and there were plans to repeat the surveys and encourage the use of the patient suggestion box.

  • There was evidence that the GPs and interim practice manager had responded to the actions required following the issue of the warning notice to ensure compliance with the regulations. They had demonstrated good leadership in the steps taken to address the issues of concern.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

01/08/2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Arun Tangri on 1 August 2016. Overall the practice is rated as Requires Improvement.

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

  • There was limited assurance about safety. For example, arrangements to manage fire safety were not operated effectively.

  • There were effective arrangements were in place to safeguard children and vulnerable adults from abuse. Staff demonstrated knowledge of the actions they would take to safeguard patients and there was evidence of engagement with the health visiting service to coordinate care for vulnerable children.

  • The practice demonstrated a caring approach to the wellbeing of their patients by referring those who were likely to be isolated to a social care scheme that encouraged interaction. The scheme was open to all ages and accommodated housebound patients. Positive outcomes were observed when a patient previously referred became a champion of the scheme and a support for other patients.

  • The practice planned and co-ordinated patient care with the wider multi-disciplinary team to deliver effective and responsive care to keep vulnerable patients safe. There was active use of the care coordinator to integrate care with other services. Feedback from other healthcare agencies was positive about their working relationship with the practice.
  • 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 (PPG).

However, the areas where the provider must make improvements are:

  • Ensure effective arrangements are in place with regards to fire safety including carrying out fire drills and actions identified in fire risk assessments.

  • Ensure recruitment arrangements include all necessary pre-employment checks for all staff to make sure risks to patients have been identified, assessed and recorded where appropriate.

  • Ensure staff undertaking lead roles have the appropriate development and supervision. For example, staff taking lead roles in infection control and fire wardens or marshals.

  • Implement processes to ensure effective communication with staff. This will ensure there is a process to share the learning from incidents and complaints received in the practice including monitoring of trends.

The areas where the provider should consider improvements are:

  • Monitor the arrangements for managing uncollected signed prescriptions to ensure they are checked on a regular basis and patients are followed up where necessary.

  • Consider a process to record actions taken in relation to medicines alerts received.

  • Carry out a risk assessment to consider the need for children’s masks for use with the defibrillator in case they are required in an emergency.

  • Consider arrangements for oversight of staff training to ensure all training considered to be essential is completed.

  • Continue to review access to nurse and GP appointments and feedback from patients on waiting times by planning and monitoring staffing needs.

  • Consider a documented business plan to outline practice vision and future strategic planning.

The inspection identified breaches of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Good governance. Therefore, a Warning Notice was issued to the provider on 11 November 2016 and the provider is expected to be compliant with the notice by 15 December 2016.

Where a service is rated as inadequate for one of the five key questions or one of the six population groups or overall, it will be re-inspected within six months after the report is published. If, after re-inspection, the service has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group or overall, we will place the service into special measures. Being placed into special measures represents a decision by CQC that a service has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

29 October 2013

During a routine inspection

We spoke with twelve people who used the service. Comments included, "It's alright is this practice. I've had a problem that the doctor spotted and [they] referred me to Nottingham [hospital]. It's sorted now but [they] keep an eye on me. When you want an appointment you actually get it."

We spoke with three members of staff. One staff member said, 'I like working here." Another commented on the support they received saying, 'We can always ask the doctors anything we're not sure about. They'll always take time out to explain things.'

Most patients we spoke with told us there were no problems getting an appointment although some people said that they had experienced lengthy and unexplained delays waiting to see the doctor. Most patients said their views about their care and treatment were listened to and their needs were met.

Staff received professional training and support and they understood how to respond appropriately to complaints and signs and allegations of concern about patients safety and well-being.