The Care Quality Commission
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Archived: Dr Ali & Partners

Overall: Good read more about inspection ratings

Northfield Health Centre, 15 St Heliers Road, Northfield, Birmingham, West Midlands, B31 1QT (0121) 475 1534

Provided and run by:
Dr Ali & Partners

All Inspections

5 April 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Dr Ali & Partners on 2 December 2015. The practice was rated requires improvement for providing safe services and for being well-led. The overall rating for the practice was requires improvement.

We found the practice required improvement in these areas due to breaches in regulations relating to safe care and treatment. This was because the practice did not have an emergency medicine in stock which can be required during coil fitting to keep patients safe. The practice had not assessed the risk of not having this in stock at the time of the inspection.

We also found other areas where the practice should improve. These findings were as follows:

  • Proof of identity was not always checked for locum doctors employed by the practice.

  • The practice did not fully complete clinical audits to identify improvements made.

  • Not all GPs at the practice could evidence how they understood how the Quality and Outcomes Framework (QOF) could be used to improve practice.

  • Patient consent for medical procedures was not always documented.

The full comprehensive report on the December 2015 inspection can be found by selecting the ‘all reports’ link for Dr Ali & Partners on our website at www.cqc.org.uk.

On 5 April 2017 we carried out an announced, follow-up comprehensive inspection to confirm 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 2 December 2015. This report covers our findings in relation to those requirements.

Our key findings were as follows:

  • People were protected by a strong, comprehensive safety system and a focus on openness, transparency and learning when things went wrong. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Opportunities for learning from internal and external incidents were maximised.

  • Risks to patients were comprehensively assessed and well managed.

  • The practice had added the emergency medicine required for coil fitting to their stock. We saw that a specific coil fitting emergency drug box, containing the emergency medicine required, was situated in the treatment room used for coil fitting.

  • Proof of identity was now requested consistently as part of a staff recruitment template.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff were sufficiently trained and had the appropriate knowledge and experience to effectively deliver care and treatment.

  • Patient outcomes were in line with or above local and national averages.

  • All GPs fully understood how they could use QOF to monitor and improve performance.

  • The practice had implemented a programme of continuous clinical audit, which included completed audit cycles to assess the effectiveness of improvements made.

  • Patients said they were treated with compassion, dignity and respect and that they were suitably involved in their care and decisions about their treatment.

  • The practice had good facilities and was well equipped to treat patients and meet their needs.

  • 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.

  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

  • The provider was aware of and complied with the requirements of the duty of candour.

The practice is now rated as good for providing safe services and for being well-led. The overall rating for the practice is now good.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

2 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 2 December 2015.

During our previous inspection of this practice in February 2015 we had found breaches of legal requirements. The practice wrote to us to say what they would do to meet legal requirements in relation to these breaches. The breaches related to regulations 12, 19 and 21 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponded to regulations 12 and 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this announced comprehensive inspection to check that they had followed their plan and to confirm that they now met legal requirements.

Our key findings were as follows:

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. The salaried GP regularly carried out coil fitting but we noted that the practice did not have any atropine which is a medication to treat slow heart rate which can occur during coil fitting. We received evidence that this had been rectified by the practice following the inspection.

  • Proof of identity was not always requested when the practice employed locum doctors despite the completion of all other appropriate checks.

  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff received training appropriate to their roles and further training needs were identified and planned.

  • Patients said they were treated with respect and involved in decisions about their treatment and care.

  • Information about services and how to complain was available and easy to understand.

  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients and acted on this.

However there were areas of practice where the provider needs to make improvements.

Action the provider must take to improve:

  • The practice must ensure that they have effective systems in place to assess and monitor the emergency medicines they have in stock so that they are able to respond appropriately in the event of a medical emergency.

The provider should:

  • Ensure that proof of identity is always checked for new employees.

  • Implement a programme of continuous audit to enable the practice to complete audit cycles and gauge the effectiveness of the improvements it makes.

  • Ensure that GPs consistently understand how they can use the Quality and Outcomes Framework (QOF) to improve quality.

  • Keep the practice’s consent policy and procedures under review to ensure that appropriate consent is always obtained in line with legal requirements and national guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

24 February 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Ali and Partners, Northfield Health Centre on 24 February 2015. Overall the practice is rated as requires improvement.

Specifically, we found the practice to be good for providing an effective, responsive and caring service. However improvements were needed to ensure that all aspects of the service were safe and well led. It required improvement for providing services for people with long term conditions, older people, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

  • Staff were clear about their responsibilities to raise concerns, report incidents and near misses and there was evidence of learning from incidents.
  • Systems and processes to manage risks to patients safety were not always in place or sufficiently robust. For example, improvements were required in the management of unforeseen events, the premises, equipment and infection control procedures.
  • Data showed patient outcomes were average for the locality. Although some audits had been carried out, we saw no evidence that audits were driving improvement in performance to improve patient outcomes.
  • Patients were complimentary about the staff at the practice and said they were caring, listened and gave them sufficient time to discuss their concerns. Patients said they were involved in decisions about their care and treatment.
  • Urgent appointments were usually available on the day they were requested. Patients reported that they were satisfied with access to appointments.

The areas where the provider must make improvements are:

  • Implement effective systems in the management of risks to patients and others against inappropriate or unsafe care. This should include effective management of unforeseen events, the premises, equipment, and medication storage.
  • Ensure that all staff including locum GPs are suitable to work at the practice. This will include ensuring that staff remain registered with their appropriate professional body.
  • Ensure processes are in place to assess the risk, prevent, detect and control the spread of infection. This would include effective infection control audit and appropriate training for staff.

In addition the provider should:

  • Ensure that staff are aware of the wide range of events that could be classified as a significant event and their responsibility for reporting these.
  • Ensure that it is clear which staff at the practice hold lead roles and update policies to reflect this.
  • Ensure that contact details are freely available to staff to enable them to report an allegation of adult abuse.
  • Ensure staff have a clear understanding of their role and responsibility in regard to their chaperone duties.
  • Ensure that information is freely available to patients regarding the process for making a complaint and who to refer to if they are not satisfied with the practice’s handling of the complaint or the outcome.
  • Ensure that clinical audit cycles are completed in order to demonstrate improvements made to patient care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice