Letter from the Chief Inspector of General Practice
We carried out a comprehensive inspection of Dr M L Swami & Partners on 15 January 2015. We have rated the overall practice as inadequate.
Specifically, we found the practice inadequate for providing safe services and being well led. It was also inadequate for providing services for all the six population groups.
Improvements were also required for providing effective services. It was good for providing caring and responsive services.
Our key findings across all the areas we inspected were as follows:
Patients were at risk of harm because systems and processes were not in place and implemented in a way to keep them safe. We found concerns in recruitment, infection control, staffing, medicine management, anticipating events, quality and monitoring systems and dealing with emergencies.
We found patient needs were not always assessed in line with professional guidelines. The practice did not have system in place to carry out completed (a minimum of two cycles) clinical audits. Multidisciplinary working was taking place but was generally informal and record keeping was limited or absent
We found the practice had not taken all measures to identify, assess and manage risk. The practice did not have a documented business or strategic plan in place.
Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. Information to help patients understand the services available was easy to understand.
The areas of practice where the provider must make improvements are:
Action the provider MUST take to improve:
- Ensure all recruitment and employment information required by the regulations are documented in all staff members’ personnel files.
- Ensure all staff identified as requiring a DBS check have one undertaken as soon as possible. Undertake a risk assessment to determine which members of staff require a Disclosure Barring Service (DBS) check and which members do not.
- Ensure there are systems in place to regularly assess and monitor the quality of the services provided. And to identify, assess and manage risks relating to health, welfare and safety of patients.
- Ensure appropriate clinical staffing levels are in place.
- Ensure arrangements are in place to deal with emergencies and major incidents.
- Ensure systems are in place to monitor fridge temperatures. To ensure systems are in place for all medicines to be stored safely and securely.
- Ensure systems are in place to safeguard patients against the risk of abuse.
- Ensure staff receive regular appropriate training, specific to their role. This includes, training in, safeguarding, infection control and chaperoning.
- Ensure appropriate infection control systems are in place, in line with national guidelines.
Action the provider SHOULD take to improve:
- Implement recording systems, to document clinical and multidisciplinary meetings that take place.
- Ensure systems are in place to undertake completed clinical audits regularly
- Ensure systems are place to ensure lessons are learnt from complaints and significant events.
On the basis of the ratings given to this practice at this inspection, I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care we will take steps to cancel its registration with CQC.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice