Archived: Drs Shrivastava & Raolu

Updated 4 May 2017

Dr Shrivastava and Raolu practice is situated within a purpose built surgery in a building known as Maltby Services Centre in Maltby, Rotherham. This was built in 2008 and provides a joint service centre comprising of Local Authority offices, leisure facilities and NHS services.

The surgery operates over two floors but all the patient facilities are on the ground floor.

The practice provides General Medical Services (GMS) for 3,200 patients in the NHS Rotherham Clinical Commissioning Group (CCG) area.

There are two GP partners, one male and one female. The nursing team comprises of one nurse practitioner, two practice nurses and a health care assistant. There is a practice manager and administration and reception team.

The practice reception hours are 8am to 6.30pm, Monday to Friday. Surgery times are 8am to 6.30pm Monday to Friday.

Out of hours services are provided by Local Care Direct. Calls are diverted to this service when the practice is closed. A walk-in centre is available at Rotherham Community Health Centre

Updated 4 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Shrivastava and Raolu on 12 January 2016. The overall rating for the practice was good but with requires improvement for safety. The full comprehensive report for the 12 January 2016 inspection can be found by selecting the ‘all reports’ link for Drs Shrivastava and Raolu on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 23 February 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 12 January 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.

Improvements had been made since our last inspection on 12 January 2016. Our key findings were as follows:

• Recruitment procedures had been improved. Disclosure and barring Service (DBS) checks and references had been obtained prior to employment. We also found DBS checks for staff who acted as chaperones and staff vaccination and immunity status checks had been obtained since the last inspection.

• Health and safety procedures had been improved. Control of substances hazardous to health and sharps injuries risk assessments had been developed and implemented. Staff had received training in fire safety and infection prevention and control (IPC). The IPC procedure had been updated.

• Processes to ensure staff had appropriate medical indemnity insurance had been improved. Staff had medical indemnity insurance in place and the practice had also implemented records to enable the practice to monitor that their insurance was up to date.

• Staff told us they felt  more involved in discussions about how to run and develop the practice and regular practice meetings had been held.

• Clinical supervision had been provided since the last inspection and regular practice nurse meetings had been implemented since the beginning of 2017.

The areas where the provider should make improvement are:

• At our last inspection on the 12 January 2016 we found the practice had a defibrillator. This equipment was shared with a  neighbouring practice and was held in a shared utility room. We observed that the equipment was stored in a box which was labelled, however a clipboard had been placed on the box and the label was hidden so the equipment may not have been easy to locate in an emergency. At this inspection we observed a similar situation with a box obscuring the label. This arrangement should be reviewed with the other practice to ensure this equipment is clearly displayed.

• At our last inspection on 12 January 2017 we found staff induction was not recorded. At this inspection, the practice manager told us staff induction was not recorded although staff told us induction had been recorded for the most recently employed member of staff. Evidence of induction records could not be provided on the day of inspection as the member of staff who held these was off duty. They told us these would be provided following the inspection but at the time of writing the report CQC had not received a copy of the document. The processes for recording induction should be reviewed and applied consistently and records should be available.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 2016

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

• The nursing team had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was 89.5% which was similar to the CCG, and national averages of 82.7% and 89.2%. We saw detailed assessments of need for patients with diabetes.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. 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.

Updated 3 March 2016

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

• The nursing team had lead roles in long term condition management disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was 89.5% which was similar to the CCG, and national averages of 82.7% and 89.2%. We saw detailed assessments of need for patients with diabetes.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. 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.

Updated 3 March 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 had a higher than average percentage of patients in the older age groups. We saw there were detailed assessment processes in place for patients over 75 years which took account of social issues and needs as well as their health needs.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 3 March 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 online appointment and prescription services as well as a range of health promotion and screening that reflects the needs for this age group.

• The practice offered extended hours from 7.30am to 8am on a Tuesday and until 8pm on a Wednesday for working patients who could not attend during normal opening hours.

Updated 3 March 2016

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

• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was better than the CCG and national average of 84%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice also worked closely with the voluntary sector in providing support for patients and carers and staff had completed training in dementia with a carers support group.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 3 March 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 homeless people, travellers 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 practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. 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.