You are here

Dr Bathla & Partners- Soho Road Primary Care Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 14 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Bathla and Partners practice on 30 November 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

  • Risks to patients were assessed and well managed.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • Feedback from patients about their care was consistently positive.

  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • 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.
  • There was a clear leadership structure and they had detailed knowledge of the population groups, the clinical conditions that exist in their area and the challenges that they face.
  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients' needs.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.

We saw areas of outstanding practice:

  • Staff competencies were assessed annually by external specialists for example, public health nurse for annual health checks, The practice initiated this quality assurance process to support staff with their personal development, to provide the management team with validation and reassurance that work was completed correctly, providing evidence of the quality of service provided. Staff told us on the day that this process gave them confidence and demonstrated that the practice were interested in their development. This initiative resulted in increased diagnosis of patients suffering with Dementia, atrial fibrillation and hypertension, with increased referrals for healthy living advice.

The areas where the provider should make improvement are:

  • The practice should continue to support patients to attend the national screening programmes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 14 February 2017

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events

  • Lessons were shared to make sure action was taken to improve safety in the practice.

  • When things went wrong patients received reasonable support, truthful information, and a written apology. They were told about any actions to improve processes to prevent the same thing happening again.

  • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

  • Risks to patients were assessed and well managed.

Effective

Good

Updated 14 February 2017

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average.

  • The practice were proactive in managing unplanned A&E attendances and hospital admissions.

  • The practice initiated a recruitment day for nurses and reception staff to overcome the challenges they faced.

  • Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • Staff competencies were assessed annually by external specialists for example, public health nurse for annual health checks. The practice initiated this quality assurance process to support staff with their personal development, to provide the management team with validation and reassurance that work was completed correctly, providing evidence of the quality of service provided. This initiative resulted in increased diagnosis of Dementia, atrial fibrillation and hypertension, with increased referrals for healthy living advice.

  • Clinical audits demonstrated quality improvement.

  • There was evidence of appraisals and personal development plans for all staff.

  • The practice demonstrated comprehensive learning and sharing of information with other health care professionals through structured meetings and comprehensive minutes.

Caring

Good

Updated 14 February 2017

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed patients rated the practice higher than others for several aspects of care.

  • 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.

  • The practice had a very high number of minority groups registered and patients from these groups spoken with praised the service they received which included the leaflets and appointment sign in, in different languages language and the support from the PPG members on how to use this.

  • The practice had a shower room available for homeless patients to use.

Responsive

Good

Updated 14 February 2017

The practice is rated as good for providing responsive services.

  • The practice had a detailed understanding of their population groups. For example they had undertaken a survey of the numbers of patients in each ethnic group this identified a high number of 85% in one particular group the practice employed an interpreter for one day a week and arranged clinics on this day for this population group.

  • The practice offered extended hours appointments in the evenings and on Saturday mornings from 9am to 1pm.
  • The practice altered their appointment profile to suit patients’ needs during Ramadan.
  • There were longer appointments provided for patients with a learning disability and long term conditions.
  • Information was available for patients on the practice website and in the waiting area in a number of languages. The practice also provided information in large print.
  • The practice provided an in-house walk in counselling service and psychiatric review service with a one hour response time.
  • The practice held regular education programmes for patients.

  • 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 and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Outstanding

Updated 14 February 2017

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

  • The practice was able to articulate its current challenges and opportunities within its local context and emerging national programmes. They had a clear understanding at a high level of their overall clinical and managerial performance.

  • The practice had detailed knowledge of the population groups, the clinical conditions that existed in their area and the challenges that they faced. They had reviewed the use of interpreters and had introduced a more efficient way to use them, for example dedicated clinics for particular population groups.

  • The practice had considered the ethnic makeup of their staff in order that they could overcome the communication challenges which their diverse population presented. The practice had invested in staff development

  • Governance and performance management arrangements had been proactively reviewed and took account of current models of best practice.

  • The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.

  • The practice reviewed the competencies of staff and the practice systems and processes on a regular basis.

  • 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.

  • There was a strong focus on continuous learning and improvement at all levels.
Checks on specific services

People with long term conditions

Outstanding

Updated 14 February 2017

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

  • Performance for diabetes related indicators was 100%, compared to the CCG average of 88% and the national average of 91% the exception reporting for this indicator was 7% compared to the CCG and national average of 10%.

  • The percentage of patients with COPD that had had an influenza immunisation was 98% which was similar to the CCG and national average.

  • The practice demonstrated how it focused its quality improvement programme through specific projects, they had targeted hard to reach diabetic groups through PPG led clinical education workshops and the initiation of additional recall systems for these high risk groups.

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

  • 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.

  • The practice held a list of patients who required palliative care and their GP acted as the lead. The gold standards framework was used for the coordination of end of life care.

Families, children and young people

Good

Updated 14 February 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 who were at risk, for example, children and young people who had a high number of A&E attendances. This included a hospital did not attend (DNA) follow up system for children.

  • 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 held regular clinical meetings for children who had been identified as at risk, child welfare concerns and safeguarding issues were discussed to ensure awareness and vigilance. The practice held regular meetings with Health Visitors to discuss any concerns and safeguarding.

  • Appointments were available outside of school hours and the premises were suitable for children and babies.

  • New technology was available for patients who choose to utilise them, such as online access, text message cancellation and self-check in.

Older people

Good

Updated 14 February 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.

Working age people (including those recently retired and students)

Good

Updated 14 February 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.

  • The practice provided a pre-bookable extended hour’s service from 8am until 11.30am each Saturday morning.

  • The practice provided NHS health checks to those in the over 40 to 74 age groups.

  • New technology was available for patients who choose to utilise them, such as online access, text message cancellation and self-check in.

People experiencing poor mental health (including people with dementia)

Good

Updated 14 February 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 100%, compared to the CCG average of 91% and the national average of 93%, the exception reporting for this indicator was 8% compared to the CCG average of 10% and national average of 11%. For example, 92% of patients with severe poor mental health had a recent comprehensive care plan in place compared with the CCG average of 90% and national average of 88%.

  • Clinical staff had received training in the Mental Capacity Act and used this when assessing appropriate patients and the practice carried out advance care planning

  • The practice provided an in-house walk in counselling service and psychiatric review service with a one hour response time.
  • 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.

People whose circumstances may make them vulnerable

Good

Updated 14 February 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 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 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.

  • The practice ensured that practice letters, documentation, self-check-in and their website was available in various languages to meet local needs.

  • The practice had a shower room available for homeless patients to use.

  • The practice held a carers’ register and members of staff and the PPG were carers champions.