Archived: Dr Javier Oscar Salerno

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the practice on 6 October 2014. 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 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: (Regulated Activities) Regulation 19: Fit and proper persons employed.

We undertook this focussed inspection on 17 December 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 Javier Oscar Salerno 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. Non –clinical staff undertaking the role of chaperoning had current Disclosure and Barring Checks completed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 January 2015

The practice is rated as good for the population group of people with long term conditions.

The practice offered patients diagnosed with conditions such as diabetes, epilepsy, coronary heart disease and chronic obstructive pulmonary disease on going care monitoring and the name of their named professional as a first point of contact. These patients were offered annual flu vaccination as per national guidance and reminders were sent for those who had still not attended including home visits.

The nurses offered disease management reviews. The nurses referred patients to the GPs if change of medicines was required.

Asthmatic patients had regular reviews which included checks to ensure they were using their nebulisers according to instructions. Diabetes patients were offered a foot assessment and referral to specialist services.

Updated 22 January 2015

The practice is rated as good for the population group of families, children and young people. The practice had a policy to offer same day appointments to children aged 0-12months.They held weekly child health clinics. This clinic was run by the GPs with the nurse. Women were offered six weeks post-natal checks and the practice worked closely with local maternity services and midwives. The GPs examined babies at eight weeks and vaccinated them at eight weeks. The nurses continued the childhood vaccination programme.

The practice held meetings with the local safeguarding teams .However the GPs told us that accessing the Health visiting services in Croydon was difficult. There had been numerous changes to service delivery and as such they no longer had a named health visitor. They told us that this had been feedback to the local Clinical Commissioning Group.

Weekly family planning clinics and Sexually Transmitted Disease advice was also offered to young people and teenage mothers.

Updated 22 January 2015

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

 All patients aged 75 and over had a named GP. Patients were offered an annual health check offered at the practice or at home for those patients that could not travel to the practice. This assessment assessed physical health, mobility, nutrition needs and social needs. The practice had a named social worker they worked closely with and made referrals to.

The GPs visited a local nursing home and were involved in care planning of those patients. The practice also had a local hospice centre attached to them. The care of these patients was planned with the local palliative team. The practice arranged and held meetings with the district nurses, the end of life care team and the hospice on a regular basis.

Updated 22 January 2015

The practice is rated as good for the population group of the working-age people (including those recently retired and students).Late evening appointments were available for working patients twice a week.

Patients aged 40 -74 years were offered health checks in accordance to local and national guidance. The practice offered Well Man and Well Woman checks with the nurse. This was an opportunity to discuss any aspect of general health such as dietary problems, stress, alcohol consumption, smoking and all aspects of women`s health; including breast examination, the menopause, cervical smears and contraception.

Updated 22 January 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). 98.2% of people experiencing poor mental health had received an annual physical health check. While 100% of patients with dementia had received yearly checks. The practice maintained a register of patients experiencing poor mental health. These patients were reviewed on a regular basis and had a named GP.

Reviews involved medication, general health, and psychiatric assessment. The practice made appropriate referrals to the community psychiatric team. Leaflets were available on local services that patients could self-refer to such as “Mind”. However the GPs told us that the care delivered to patients with mental health conditions in Croydon needed improvement because services were undergoing review and as such did not always offer care that was collaborated with other organisations such as GPs.The practice offered patients normal general practice services such as smear testing, breast screening and advice on prostate cancer symptoms.

Updated 22 January 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice operated a “red flag” system for patients in vulnerable circumstances. The purposes of this was to identify these patients on the record system to ensure none of their care needs were not followed up on. The practice had a small number of patients with learning disabilities. The practice had carried out annual health checks for people with learning disabilities and 100 % of these patients had received a follow-up. The check also covered general health, social environment, medication review, mood and lifestyle.

The practice registered patients from the travelling communities. Services were planned according to need recognising that patients would move frequently and as such opportunistic appointments were available. Screening services such as smear testing, blood pressure monitoring and smoking cessation advice was offered.

The practice had produced a leaflet they named, “the helping hand”. It contained sign posting information to patients at risk of abuse or in other vulnerable circumstances on services that were available locally in Croydon offering support.

Staff at the practice told us they would offer services tailored for the homeless but they did not have any patients registered as homeless.