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Rahman Practice Good Also known as Canvey Village Surgery

Inspection Summary


Overall summary & rating

Good

Updated 21 March 2016

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection at Rahman Practice on 15 September 2015. At this inspection the practice was rated as good overall and in particular rated as good for providing effective, caring, responsive and well-led services and requires improvement for providing safe services.

During the inspection on 15 September 2015 we found that;

  • Recruitment checks prior to staff members starting their employment had not been obtained consistently. For example; proof of identification, references, qualifications, registration with the appropriate professional body and the appropriate checks through the ‘Disclosure and Barring Service’ (DBS) when needed.
  • The practice did not have access to emergency oxygen for patients.
  • The practice had not reviewed and brought up to date the practice policies and procedures for example; safeguarding and infection control to ensure they were aligned with current best practice guidelines and legislation.
  • The practice had not undertaken an infection control audit nor provided relevant training for their staff.

The practice was issued with a requirement notice for improvement.

Following this inspection the practice sent us information that outlined the actions they intended to take to improve, and the date they would be implemented. We were then provided with evidence that the practice had implemented the required improvements.

To follow-up on our previous inspection and ensure the practice had made the required improvements, we carried out a desk-based inspection of the Rahman Practice on 24 February 2016, based on the information they sent us after the inspection.

Our key findings during this desk-based follow-up inspection were as follows:

  • The practice provided evidence of their recruitment checks, their revised recruitment policy and induction procedure.
  • Evidence that patients had access to emergency oxygen and a newly purchased defibrillator (which provides an electric shock to stabilise a life threatening heart rhythm).

  • Reviewed and updated practice policies were sent to us showing they now met current best practice guidance and legislation. They also identified the practice lead for example; the infection control lead and the safeguarding lead.
  • The practice provided evidence of regular infection control risk assessment audits and that relevant staff had received training in infection control procedures.

  • Chaperones had received training and DBS checks.

We were therefore satisfied the provider had made all of the improvements identified as a result of the inspection on 15 September 2015.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 21 March 2016

The practice is rated as good for providing safe services.

  • The practice had provided evidence of recruitment checks, their recruitment policy, and induction procedure had been revised and met current guidance. For example DBS checks for chaperones.

  • Patients had been provided access to emergency oxygen and a newly purchased defibrillator (which provides an electric shock to stabilise a life threatening heart rhythm).

  • Practice policies had been reviewed and updated to show they met current best practice guidance and legislation.

  • The practice had undertaken regular infection control risk assessment audits and relevant staff had been trained in infection control procedures.

Effective

Good

Updated 21 March 2016

As the practice was rated as good for providing effective services during the inspection on 15 September 2015, we did not need to inspect this domain during the focused inspection on 24 February 2016.

Caring

Good

Updated 21 March 2016

As the practice was rated as good for providing caring services during the inspection on 15 September 2015, we did not need to inspect this domain during the focused inspection on 24 February 2016.

Responsive

Good

Updated 21 March 2016

As the practice was rated as good for providing responsive services during the inspection on 15 September 2015, we did not need to inspect this domain during the focused inspection on 24 February 2016.

Well-led

Good

Updated 21 March 2016

As the practice was rated as good for providing well-led services during the inspection on 15 September 2015, we did not need to inspect this domain during the focused inspection on 24 February 2016.

Checks on specific services

People with long term conditions

Good

Updated 4 February 2016

The practice is rated as good for providing effective, caring, responsive and well-led services and requires improvement for safe services. The concerns which led to these rating apply to everyone using the practice, including this population group.

Patients in need of chronic disease management and those at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. There were a number of specialist clinics for patients with long term conditions. All these patients had a named GP and a structured annual review to check health and medication needs. For patients with the most complex needs, the named GP worked in unison with the care co-ordination service combining multiple agencies to work collaboratively.

The group of patients considered most at risk had been given a by-pass mobile number. This gave them priority access to speak with a clinician.

Those patients on the palliative care register in need of care were discussed at the three monthly multidisciplinary team meetings.

Families, children and young people

Good

Updated 4 February 2016

The practice is rated as good for providing effective, caring, responsive and well-led services and requires improvement for safe services. The concerns which led to these rating apply to everyone using the practice, including this population group.

There were systems in place to identify and follow up children who were at risk, for example, children and young people who had a high number of A&E attendances.

Immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours.

The practice told us they supported patients to utilise specialist family services if they had a financial or social problem and social services.

Older people

Good

Updated 4 February 2016

The practice is rated as good for providing effective, caring, responsive and well-led services and requires improvement for safe services. The concerns which led to these rating apply to everyone using the practice, including this population group.

Nationally reported data showed that outcomes for patients were similar to expected nationally for conditions commonly found in older people. The practice offered caring, personalised care to meet the needs of the older people in the population and had a range of services. For example the practice identified patients aged 75 or over with a fragility fracture and treated them with an appropriate bone-sparing agent. The practice also developed care plans as part of the admission avoidance enhanced service for people who are at risk of unplanned hospital admissions.

The practice offered older people home visits, and urgent appointments to meet their needs. They also encouraged older people who live on their own to find friends with the local be-friending service.

Working age people (including those recently retired and students)

Good

Updated 4 February 2016

The practice is rated as good for providing effective, caring, responsive and well-led services and requires improvement for safe services. The concerns which led to these rating apply to everyone using the practice, including this population group.

The needs of this population had been identified and had amended the services offered. The practice was proactive in offering online appointments and prescriptions. They also provided patients with access to a full range of health promotion literature, screening service, and health checks that reflected the needs of this population group.

They had introduced a Skype appointment system enabling patients to make a Skype appointment during the day from work to discuss their condition with the doctor of their choice. We also saw the practice offered a computer software programme called Web GP on their website, this enabled patients to enter their symptoms. The programme asked patients relevant questions and then signposted them with the right service provision. The practice was sent information about the consultation the following day and the GPs responded within 24 hours.

Appointments were available each morning and evening at times that were flexible for chronic disease monitoring for this group within the clinics.

People experiencing poor mental health (including people with dementia)

Good

Updated 4 February 2016

The practice is rated as good for providing effective, caring, responsive and well-led services and requires improvement for safe services. The concerns which led to these rating apply to everyone using the practice, including this population group.

Data available to us for 2013 to 2014 showed the practice carried out face to face reviews of all patients with dementia.

The practice sign-posted patients experiencing poor mental health to access various support groups and voluntary organisations for example a therapy service which was accessible within the practice fortnightly. Patients in this population group who had attended accident and emergency (A&E) where they may have been experiencing poor mental health were followed up.

People whose circumstances may make them vulnerable

Good

Updated 4 February 2016

The practice is rated as good for providing effective, caring, responsive and well-led services and requires improvement for safe services. The concerns which led to these rating apply to everyone using the practice, including this population group.

The practice had identified patients living in vulnerable circumstances including those in a care organisation or with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. Vulnerable people had been signposted to assist them in identifying and accessing support groups and voluntary organisations. Those people living alone were supported to access a volunteer run be-friending service provided in the community to support them.

Staff had received training and knew how to recognise signs of abuse in vulnerable adults and children. They were aware of their responsibilities regarding information sharing and the documentation of safeguarding concerns. Staff knew who the safeguarding lead at the practice was and who to contact with any concerns.

GPs at the practice referred to the local exercise prescription programme. We were told many of the vulnerable patients with chronic illnesses were part of this scheme.

Where necessary frail patients were provided access to a social worker and a community matron to support their care and patient needs were discussed at monthly frailty meetings.