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Archived: Dr Ramesh Sharma Good Also known as Borough Medical Centre - Dr RK Sharma

Reports


Inspection carried out on 11 Dec 2019

During a routine inspection

We carried out an inspection of this service on 11 December 2019 following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a significant change to the quality of care provided since the last inspection. We previously inspected the practice on 22 April and 15 October 2015 and rated it Good overall. At this inspection we found the service to be Good in all the key questions and all population groups except People of Working Age which was rated Requires Improvement.

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 except People of Working Age which was rated Requires Improvement.

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

• There was a formal process for reviewing patients prescribed high risk medicines to monitor their health.

• The practice was correctly monitoring indemnity arrangements and professional registrations of clinical staff.

• Staff demonstrated competent knowledge of safeguarding, fire and infection control training.

• Safeguarding arrangements and the mechanisms for reporting significant events were clear.

We rated the practice as Good for providing Effective services because:

• There was clear care planning for patients.

• The practice had systems to review and monitor the quality of care provided by locum staff and all staff had been appraised.

• The practice undertook effective joint working with other organisations.

• Performance indicators for patients with childhood immunisation rates and cervical screening were below targets. The practice was working to address these areas and this was evidenced by the improvements demonstrated by unvalidated data following various approaches towards communication and information for parents.

We rated the practice as Good for providing Caring services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

• The practice had identified the carers within their practice list and had implemented support for them.

We rated the practice as Good for providing Responsive services because:

• The complaints policy was accessible and had been updated. Complaints had been responded to and recorded.

• The appointment systems were easy to use and patients were supported to access appointments.

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

• The leadership governance and culture supported the delivery of high-quality person-centred care.

• The arrangement for governance and performance management were clear and operated effectively.

• There was action taken in response to feedback from staff and patients.

Whilst we found no breaches of regulations, the provider should:

• Put in place a safety net to chase any patients who fail to attend follow up appointments;

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

Inspection carried out on 15 October 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the practice on 22 April 2015. Breaches of legal requirements were found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breaches of Regulation 12 HSCA (Regulated Activities) Regulations 2014 Regulation 12: Safe care and treatment 12(c).

We undertook this focussed inspection on 15 October 2015 to check that they had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Dr Ramesh Sharma on our website at www.cqc.org.uk. Overall the practice is rated as Good.

Following this focused inspection we rated the practice as good at providing safe services.

Our key finding was as follows:

  • The practice had addressed the issue identified during the previous inspection. Staff had undertaken training in fire safety and the practice nurse`s basic life support refresher training had been renewed. Chaperone training had been booked.
  • Risks to patients were assessed and managed, including those for infection control.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 22 April 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Ramesh Sharma on 22 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing effective, caring, responsive and well-led services. However we found the practice to require improvement for providing safe care. Staff did not have training in chaperoning, fire safety and the practice nurse`s basic life support refresher training had expired. We found that the practice had not protected people against the risk of the spread of, infections, including those that are health care associated.

It was also good for providing services for older people, people with long term conditions; mothers, babies, children and young people; the working age population and those recently retired.; people in vulnerable circumstances and people experiencing poor mental health .

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.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• 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 proactively sought feedback from staff and patients, which it acted on.

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

Action the provider MUST take to improve:

• Must take action to address identified concerns with infection prevention and control practice. Including ensuring COSHH guidance is followed for the disposal of cytotoxic clinical waste.

• Must take action to ensure staff have updated training in basic life support, chaperoning and Fire training.

Action the provider SHOULD take to improve:

• Ensure they develop a business plan to govern activity.

• Ensure clear responsibilities of repairing and cleaning of the premises are in place and agreed with the other practice they share facilities with.

Ensure they appoint an infection control lead to support staff in infection control practices within the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice