The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Bharathi Chowdary Chaparala Also known as Holyhead Primary Healthcare Centre

Overall: Inadequate read more about inspection ratings

1 St James Road, Handsworth, Birmingham, West Midlands, B21 0HL (0121) 554 8516

Provided and run by:
Dr Bharathi Chowdary Chaparala

Important: The provider of this service changed. See new profile

All Inspections

31 August 2022

During an inspection looking at part of the service

We carried out an unannounced focused inspection at Dr Bharathi Chowdary Chaparala on 31 August 2022. Overall, the practice is rated as inadequate.

Safe - inadequate

Effective - inadequate

Well-led - inadequate

Following our previous inspection on 17 July 2019, the practice was rated good overall and for all key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr Bharathi Chowdary Chaparala on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up concerns reported to us.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We found that:

  • The practice had no system in place to monitor potential safeguarding issues. The clinical lead had no oversight on safeguarding concerns and failed to investigate when potential risk was highlighted.
  • The practice did not have appropriate systems in place for the safe management of medicines. This included an ineffective system for the management of safety alerts, as actions had not been taken to ensure patients were informed of potential risks with certain medicines.
  • Patients on high risk medicines were not being monitored or reviewed regularly. We found examples of medicine reviews being coded as completed, however there was no evidence to demonstrate that patients’ medicines had been reviewed appropriately.
  • We found patients had not had health conditions clinically coded appropriately and the summary of their medical problems was not up to date.
  • We found patient medical records that were not accurate or up to date.
  • The practice were unable to demonstrate effective clinical supervision of staff carrying out clinical roles to ensure they were acting within their competencies. We found significant concerns in the prescribing of medicines and the lack of information recorded in patients’ consultations.
  • The practice was unable to demonstrate that risk management plans and comprehensive risk assessments had been carried out for patients.
  • Evidence based guidelines were not followed, placing patients at risk.
  • Clinical registers were not up to date and ineffective. This demonstrated a lack of clinical management of patients’ health conditions.
  • The practice culture did not effectively support high quality sustainable care.
  • The overall governance arrangements were ineffective. The practice did not have clear and effective processes for managing risks, issues and performance.
  • The practice did not always act on appropriate and accurate information.
  • The practice was unable to demonstrate effective leadership. The lack of adequate processes were putting patients at risk and the provider did not have the capability to lead effectively and drive improvement.

We found breaches of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The provider should:

  • Implement a process to encourage patients to attend for immunisations and cervical screening.

Due to the significant failings we identified in the management of patient care and treatment on the unannounced inspection on 31 August 2022 urgent action was taken to protect the safety and welfare of people using this service. Under Section 31 of the Health and Social Care Act 2008 a temporary suspension of six months was imposed on the registration of the provider in respect of the following activities Diagnostic and screening procedures, Treatment of disease, disorder or injury, Family planning, Maternity and midwifery services and Surgical procedure at Dr Bharathi Chowdary Chaparala. This notice of urgent suspension of the provider was imposed due to the seriousness of the lack of appropriate care and treatment found and because we believe that a person will or may be exposed to the risk of harm if we did not take this action. The suspension took effect from Wednesday 7 September 2022.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement, we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration. Special measures will give people who use the service the reassurance that the care they get should improve.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

17 July 2019

During an inspection looking at part of the service

We decided to undertake an inspection of this service following our annual review of the information available to us. This inspection looked at the following key questions:

  • Effective
  • Caring
  • Responsive
  • Well-led

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

We rated the practice as good for providing effective caring, responsive and well-led services. We have also rated all population groups as good except for people with long term conditions because:

  • Patients received effective care and treatment that met their needs. However, we saw high exception reporting for some long-term conditions.
  • Leaders were visible, empowered their staff and were aware of areas that required further improvement.
  • Feedback from the GP patient survey showed low patient satisfaction some of the areas including the quality of consultations with a clinician; availability and satisfaction to appointment types. The practice had reflected on the results and had developed action plans to achieve improvement.

We saw some areas of outstanding practice including:

  • The practice had set up language specific patient participation groups (PPGs). This included a Polish, Punjabi and Romanian group. This initiative allowed these patients to have involvement in the development of the practice. The practice had recently employed a Romanian speaking reception staff following feedback from the Romanian speaking PPG.
  • The practice had a developed a partnership to work closely with a local pharmacy and had held a a pre-diabetes event to educate relevant patients. It had planned to hold further events on a monthly basis. planned to hold other awareness events.

The areas where the provider should make improvements are:

  • Improve the identification of carers to enable this group of patients to access the care and support they need.
  • Continue to explore ways to reduce exception reporting for some long-term conditions as well as in other areas such as mental health.
  • Continue to explore ways to improve cancer screening uptake including bowel screening.
  • Continue to monitor the national patient survey results in view to improving patient satisfaction.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

14 April 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Bharathi Chowdary Chaparala's practice, on 14 April 2016. Overall the practice is rated as good.

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

  • Risks to patients were assessed and well managed. Patients’ needs were assessed and care was planned and delivered following best practice guidelines. The practice had clearly defined and embedded system, processes and practices in place to keep people safe and safeguarded from abuse.
  • The practice was proactive in identifying and managing significant events and all opportunities for learning was maximised.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Clinical audits were carried out to demonstrate quality improvement and to improve patient care and treatment.
  • The practice had a regular programme of practice meetings and there was an overarching governance framework which supported the delivery of the practices vision and strategy and good quality care.
  • 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
  • Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • 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.
  • The provider was aware of and complied with the requirements of the duty of candour .
  • 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.

We saw some areas of outstanding practice:

  • Sixty per cent of patients registered at the practice do not speak English as their main language. The practice had agreed with the CCG that they would register all asylum seekers and refugees in the area. To ensure that these patients could be seen promptly interpreters were available in the practice Mondays to Fridays 9am to 1pm and 4.30pm to 6.30pm. The interpreters spoke a number of languages to support the local population, for example polish, Punjabi, Mirpuri, Urdu and Hindu. The interpreters provided support during consultations, booking appointments, completing forms and arranging screening. The availability of interpreters enabled improved management of urgent same day appointments.

  • The practice had set up language specific patient participation groups. The polish group had been active for six months and was well attended. Dates and been set for the other groups, the Punjabi community group was meeting on 12 may 2016 and the Romanian community group meeting was planned for July/ August 2016. This initiative allowed these patients to have involvement in the development of the practice. As two of the groups had recently been established the practice had not arranged any joint meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

10 October 2013

During a routine inspection

We spoke with five patients, the lead GP (provider), the deputy practice manager who was also the healthcare assistant, a receptionist and the practice manager. All of the patients we spoke with were pleased with the service they received from the practice. One patient said: 'Great, everybody is nice and friendly. We are well received and well respected'.

We found that care and treatment was planned and delivered in a way that met patients' needs and protected their rights. Patients we spoke with told us they were happy with the level of care they had received.

Staff had received training in safeguarding to protect vulnerable adults and children. Appropriate guidance was available for staff to follow if abuse was suspected.

Staff we spoke with told is they were supported to deliver care to an appropriate standard.

We found that the practice had appropriate internal audit systems in place to monitor and improve the quality of the service it provided.