Dr I K Babar & Partners

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

At our last assessment, we rated this key question as GOOD. At this assessment, the rating has changed.

The service was in breach of legal Regulations in relation to safe care and treatment, good governance, staffing and fit and proper persons employed.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not ensure people's care and treatment was effective or that care or treatment was always based on a full assessment of a person’s diverse needs.

Feedback from people using the service was mixed. The results of the National GP Patient Survey were below the national and local average. For example, 87% felt the healthcare professional they saw had all the information they needed about them, compared to 92% nationally and 92% locally, and 83% felt their needs were met during their last general practice appointment, compared to 90% nationally and 91% locally. In addition 76.5% of people who responded to the GP Patient Survey felt involved in decisions being made around their care as opposed to the national average of 91.2%

Reception staff were aware of the needs of the local community. Reception staff used digital flags within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present.

Our clinical searches identified some areas where the monitoring of service users’ conditions was not up to date, or it was not apparent their condition had been monitored elsewhere, such as hospitals.

The provider’s systems are ineffective in ensuring that staff are up to date with current national legislation, evidence-based good practice and required standards.
Clinical records we reviewed demonstrated care was not always provided in line with current guidance and there was insufficient evidence that people were routinely told about current good practice that is relevant to their care, and patients were not always involved in care planning.
The results of the National GP Patient Survey were below the national and local average. For example, 81% of respondents stated that during their last appointment, they had confidence and trust in the healthcare professional they saw or spoke to, compared to 93% nationally and 92% locally.
The practice had no evidence of any recent appraisals or supervision for clinicians. The provider told us that most staff had not had an appraisal since 2020.
 

The service did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Staff within the practice did not always work well as a team to support people who used the service.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support but they did not always work with other services to ensure continuity of care, including where clinical tasks were delegated to other services.

The service did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. The service did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Staff did not always focus on identifying risks to patients’ health, including those in the last 12 months of their lives, patients at risk of developing a long-term condition and those with caring responsibilities. There was no carers register in place, and the practice did not promote the support that was available to carers in the community.

Staff supported national priorities and initiatives to improve population health, including smoking cessation and tackling obesity by displaying information within the practice waiting area.

The service did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The practice told us patients were encouraged to attend cancer screening appointments and take up vaccinations offered as part of national programmes. However, the most recently published cervical screening data showed the practice was significantly below target. The percentage of persons eligible for cervical cancer screening who were screened adequately within 3.5 years for persons aged 25 to 49 was 44% (expected rate 80%), and within 5.5 years for persons aged 50 to 64 was 71% (expected rate 80%). They were also below target for childhood vaccinations.

The service did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The practice had Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) in place for some people but none of those we examined had been reviewed. The provider advised that these would be reviewed as a priority.
Discussions with people and their families were documented, and it was recorded where people didn’t have the capacity to consent.
There was no record for any member of staff except for a locum GP completing Mental Capacity Act training.
The results of the National GP Patient Survey were below the national and local average with 77% of respondents stating that during their last appointment, they were involved as much as they wanted to be in decisions about their care and treatment, compared to 91% nationally and locally.