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Dr Satnam Sodhi Good Also known as SMS Medical Practice

Inspection Summary


Overall summary & rating

Good

Updated 26 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Satnam Sodhi on 31 October 2016. The overall rating for the practice was good. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for Dr Satnam Sodhi on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 31 August 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 31 October 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.

Our key findings were as follows:

  • Risks to patients were assessed and well managed, including those related to recruitment checks.
  • The provider had up to date policies on safeguarding and there was a new system in place to ensure that staff read and signed the policies.
  • The provider took action to ensure all staff were aware of how to access the practice’s business continuity plan.
  • All completed appraisal records included assessment of staff performance.
  • Unpublished data for long term conditions provided by the practice showed there had been improvements in patient outcomes.
  • Although some improvements had been made to improve the cervical screening uptake which included providing information in different languages, the uptake continued to be below local and national average. For example, Quality and Outcomes Framework (QOF) data for 2015/16 showed the cervical screening uptake for the practice was 67%, which was below Clinical Commissioning Group (CCG) average of 77% and national average of 81%.

The areas where the provider should make improvements are:

  • Monitor and continue to consider ways to improve the uptake of cervical screening.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 26 October 2017

The practice is rated as good for providing safe services as improvements had been made.

  • Risks to patients were assessed and well managed, including those related to recruitment checks.

Effective

Good

Updated 29 March 2017

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were below average compared to the national average in some areas, such as diabetes and atrial fibrillation.
  • Clinical audits had been carried-out and these were used to drive improvement at the practice.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • All staff had received an appraisal in the past year; however, records of appraisals did not include an assessment of the staff member’s performance.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 29 March 2017

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed the practice’s scores were comparable to the CCG and national averages.
  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available was easy to understand and accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Good

Updated 29 March 2017

The practice is rated as good for providing responsive services.

  • Practice staff reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified.
  • Most patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Information about how to complain was available and easy to understand; however, their complaints policy contained outdated information. Evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff.

Well-led

Good

Updated 29 March 2017

The practice is rated as good for being well-led.

  • The practice had a vision and plans to deliver high quality care and promote good outcomes for patients.
  • There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings.
  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty. The practice had systems in place for notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken
  • The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.
Checks on specific services

People with long term conditions

Requires improvement

Updated 29 March 2017

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

  • The practice’s achievement in the management of long-term conditions was below average in some areas. For example, overall the practice achieved 63% of the total QOF points available for diabetes indicators, compared with an average of 89% locally and 90% nationally; however, they had introduced joint consultations with GPs and a specialist diabetes nurse in order to improve outcomes for patients in this group.
  • The practice was an accredited Research Hub with the National Institute for Health Research, and recruited patients with longterm conditions for research and clinical trials when established treatment options had been exhausted.
  • Patients at risk of hospital admission were identified as a priority.
  • Longer appointments and home visits were available when needed.
  • 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.

Families, children and young people

Good

Updated 29 March 2017

The practice is rated as good for the care of families, children and young people.

  • There were systems in place to identify and follow up children living in disadvantaged circumstances and 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.
  • Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
  • The practice’s uptake for the cervical screening programme was 67%, which was below CCG average of 78% and the national average of 82%.
  • Appointments were available outside of school hours and the premises were suitable for children and babies. The practice provided in-house post natal checks.
  • We saw positive examples of joint working with midwives, health visitors and school nurses.

Older people

Good

Updated 29 March 2017

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

  • The practice’s performance in relation to conditions commonly found in older people was comparable to local and national averages. For example, the percentage of patients with hypertension who had well controlled blood pressure was 80% compared to a CCG and national average of 83% (exception reporting rate was 2% compared to a CCG and national average of 4%).
  • The practice met monthly with district nurses and the complex patient management group in order to discuss this patient group.
  • An emergency bypass phone number was available for elderly patients to ensure that they could get through to the practice.

Working age people (including those recently retired and students)

Good

Updated 29 March 2017

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 was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group; for example, the practice provided chlamydia screening and had exceeded the locally set target for screening 16-24 year olds.
  • The practice offered minor surgery, which allowed patients to receive treatment without having to attend hospital.

People experiencing poor mental health (including people with dementia)

Good

Updated 29 March 2017

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

  • Performance for mental health related indicators was comparable to local and national averages. The practice had 9 patients diagnosed with dementia and 75% of these patients had had their care reviewed in a face to face meeting in the last 12 months, compared to the CCG average of 86% and national average of 84%. The practice’s exception reporting rate for this indicator was 11% compared to the CCG and national average of 7%.
  • The practice had 28 patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses and 93% of these patients had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG average of 91% and national average of 89%. The practice had not excepted any patients for this indicator compared to the CCG average of 7% and national average of 13%.
  • The practice had an in-house counsellor for both their own patients and those registered at other patients in the CCG.
  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those 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.

People whose circumstances may make them vulnerable

Good

Updated 29 March 2017

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 those with a learning disability.
  • The practice offered longer appointments for patients with a learning disability.
  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.
  • 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.