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Inspection Summary


Overall summary & rating

Good

Updated 14 September 2018

This practice is rated as

Good

overall.

At our previous inspection in November 2017 the practice had an overall rating as Good, but we rated the practice requires improvement for providing safe services. We issued a requirement notice and the provider informed us of actions they would take in order to make improvements.

We undertook a focussed inspection on 4 September 2018 to deduce whether the improvements required had been made. Following this inspection:

  • Are services safe? – Good

We carried out the announced focussed inspection on 4 September 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether Dr M L Swami and Partners was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

At this inspection we found:

  • The practice had defined and embedded systems, processes and practices to minimise risks to patient safety.
  • Prescribing of high risk medicines ensured patients received monitoring required to take these medicines safely.
  • Test results were monitored and acted on to ensure patient care was followed up where actions were required.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 14 September 2018

During our inspection in November 2017 we identified that the practice was not always monitoring patients on high risk medicines safely and that actions regarding test results may not have been acted on due to the system in place not being fully adequate.

We also recommended the practice should consider the risks posed regarding physical access to the building.

At this inspection we found;

Risks to patients

  • The practice assessed risks to patients including those related to prescribing and the monitoring of test results.
  • An assessment of accessibility for patients with limited mobility or hearing or visual impairments had been undertaken and actions completed as a result.

Information to deliver safe care and treatment

The practice had implemented a new system to monitor, act on and file outstanding pathology results. We saw this functioned as intended and provided patients with any follow up care they needed.

Appropriate and safe use of medicines

The practice had implemented a system to monitor all patients on high risk medicines. This ensured medicines could not continuously be prescribed without the necessary checks, such as blood tests, being undertaken. This ensured that patients on such medicines received the reviews they required.

Checks on specific services

People with long term conditions

Good

Updated 26 November 2015

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

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 that their health and medication needs were being met. For those people 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 26 November 2015

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

here 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 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Older people

Good

Updated 26 November 2015

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

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Working age people (including those recently retired and students)

Good

Updated 26 November 2015

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.

People experiencing poor mental health (including people with dementia)

Good

Updated 26 November 2015

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

The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

Patients experiencing poor mental health had a care plan documented in their record in the preceding 12 months. Patients were told how to access various support groups and voluntary organisations.

It 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 received training on how to care for people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 26 November 2015

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. It offered longer appointments and carried out annual health checks for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients 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.