You are here

Drs B Bansal and D W Reade Good Also known as Hall Street Medical Centre

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 11 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs B Bansal and D W Reade on 11 October 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Safety alerts were received and acted upon.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.

  • Infection control procedures were in place.

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their 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.
  • Patients said they could make appointments easily and urgent appointments were available the same day for all children and those patients who needed them.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • 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 areas where the provider should make improvement are:

  • Review significant events and complaints on a regular basis to identify themes and trends and act on these.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 11 November 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events.

  • Lessons were shared to make sure action was taken to improve safety in the practice.

  • When things went wrong patients received reasonable support, truthful information, and an apology. They were told about any actions to improve processes to prevent the same thing happening again.

  • The practice had systems, processes and practices in place to keep patients safe and safeguarded from abuse.

  • Risks to patients were assessed and well managed, including infection and medicine risks and general health and safety risks.

Effective

Good

Updated 11 November 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average.

  • Staff assessed needs and delivered care in line with current evidence based guidance.

  • Clinical audits demonstrated quality improvement.

  • Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • There was evidence of appraisals and personal development plans for all staff.

  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 11 November 2016

The practice is rated as good for providing caring services.

  • Data from the national GP patient survey showed patients rated the practice average and higher than others for several aspects of care. For example, 88% of respondents to the survey said the last GP they saw or spoke to was good at treating them with care and concern (compared to a national average of 85%) and 94% said the last nurse they saw or spoke to was good at treating them with care and concern (compared to a national average of 91%).

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

  • Information for patients about the services available was easy to understand and accessible.

  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Good

Updated 11 November 2016

The practice is rated as good for providing responsive services.

  • The practice reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified. For example in care pathways, dementia and elderly care and the care of those at risk of unplanned admissions to hospital.

  • Patients said they had no problems making appointments and urgent appointments were available the same day for all children and those patients who needed them.

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

  • Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

  • The practice had access to translation services and could provide information in different formats.

Well-led

Good

Updated 11 November 2016

The practice is rated as good for being well-led.

  • The practice had a clear vision to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.
  • There was a clear leadership structure and staff were well supported by management.
  • There was a high level of staff satisfaction with staff having worked there for long periods of time and low staff turnover rates. Staff were supervised, felt involved and worked as a team.

  • The practice had a number of policies and procedures to govern activity. They held a variety of regular meetings which included governance issues as an agenda item.

  • There was an overarching governance framework which included arrangements to monitor and improve quality and identify risk.

  • The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty.

  • The practice had systems in place for notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken

  • The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.

  • There was a strong focus on continuous learning and improvement at all levels.

Checks on specific services

People with long term conditions

Good

Updated 11 November 2016

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

  • Nursing staff and GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

  • Performance indicators for patients with long term conditions were around or above the CCG and National average. For example:

    The percentage of patients on the diabetes register, in whom the last blood pressure reading (measured in the last 12 months) was 140/80mmHg or less was 83%. The CCG average was 82% and the national average was 78%.

    The percentage of patients with asthma, on the register, who have had an asthma review in the preceeding12 months that includes an assessment of asthma control using the three RCP questions was 81% (compared to the CCG average of 77% and national average of 75%).

  • Longer appointments and home visits were available when needed for patients with long term conditions and multiple conditions.

  • All these patients had a structured annual review to check their health and medicines needs were being met.

  • For those patients 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 11 November 2016

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

  • There 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 good for all standard childhood immunisations with immunisations uptake for all children aged five and under around 91%.

  • 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.

  • Unwell children were always offered same day/urgent appointments.

  • The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was around the national average at 82%. (CCG average – 83%, national average – 82%).

  • Appointments were available outside of school hours.

We saw positive examples of joint working with midwives, health visitors and school nurses

Older people

Good

Updated 11 November 2016

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

The practice has slightly higher numbers of older patients than the national and local clinical commissioning group (CCG) average with 25% of patients at the practice being over the age of 65. 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 avoiding unplanned hospital admissions, dementia, and end of life care.

  • The practice was responsive to the needs of older people, and offered home visits, longer appointments and urgent appointments for those with enhanced needs.

  • Nationally reported data showed that outcomes for patients with conditions commonly found in older people were good. For example the percentage of patients with hypertension in whom the last blood pressure reading was 150/90mmHg or less was 87% and higher than the CCG and national average. Whilst the percentage of patients with atrial fibrillation treated with anticoagulation or anti platelet therapy was 100% and also higher than the CCG and national average.

  • All the older patients had a named GP who coordinated their care and contacted patients over 75 following discharge from an unplanned hospital admission.

Working age people (including those recently retired and students)

Good

Updated 11 November 2016

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.

  • For example, it offered online bookings of appointments and prescription requests and offered evening appointments and telephone consultations. Appointments could be pre booked or booked on the day and emergency appointments were also available daily for those in need and all children.

  • The practice offered a full range of health promotion and screening that reflected the needs for this age group for example NHS health checks for those aged 40 to 75 years old.

People experiencing poor mental health (including people with dementia)

Good

Updated 11 November 2016

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

  • 97% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the preceding 12 months which was above the national average of 88% and CCG average of 93%.

  • 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was above the national average of 84%.

  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations and could signpost to relevant specialist services.

  • The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health and for those who did not attend appointments.

  • Staff had a good understanding of how to support patients with mental health needs and dementia. Longer appointments were offered to those patients with poor mental health.

People whose circumstances may make them vulnerable

Good

Updated 11 November 2016

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 homeless people, those with substance or alcohol misuse and those with a learning disability.

  • The practice offered longer appointments for patients with a learning disability.

  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.

  • The practice informed vulnerable patients about 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.