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Dr Srinivas Rao Dasari and Dr Raveendra Katamaneni Good Also known as Rowlands Road Surgery

Inspection Summary


Overall summary & rating

Good

Updated 24 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Srinivas Rao Dasari and Dr Raveendra Katamaneni, also known as Rowlands Road Surgery on 3 August 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Dr Srinivas Rao Dasari and Dr Raveendra Katamaneni on our website at www.cqc.org.uk.

This inspection was an announced follow up inspection carried out on 27 March 2017 to confirm that the practice had carried out their plan to meet the required improvements in relation to the breaches in regulations that we identified in our previous inspection on 3 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our key findings were as follows:

  • Since our comprehensive inspection, which took place in August 2016 documents we viewed as part of our follow up inspection showed that lessons from incidents were shared. The practice was able to demonstrate that actions had been taken to prevent the same thing happening again.

  • Previously, documents we viewed showed that some risks were not effectively managed. For example, risk associated with the building, recruitment checks and business continuity planning. During the follow up inspection we saw that risk assessments were practice specific, staff had received immunity checks and training to enable them to carry out their role safely and effectively.

  • When we carried out our comprehensive inspection, governance arrangements were not effectively managed. As a result, some

    risks had not been identified or well managed and we saw some policies which were not practice specific. At the follow up inspection we saw that

    arrangements for identifying, recording and managing risks, and implementing mitigating actions had been established

    . Policies had been reviewed and were practice specific.

  • Quality Outcomes Framework (QOF) performance during 2015/16 showed that the practice completed 75% of dementia reviews. Unverified data provided by the practice during the follow up inspection showed that this had increased to 80%. Staff we spoke with explained that this increase was due to correct recording and proactive identification of dementia patients.

  • Staff we spoke with during the comprehensive inspection explained that the last multidisciplinary meeting held to discuss patients with end of life care and complex needs had not taken place for over 12 months. Members of the clinical team we spoke with as part of this inspection told us that the practice ensured that end of life care was delivered in a coordinated way which took into account the needs of different patients, including those who may be vulnerable because of their circumstances. For example, the practice attended palliative care meetings every three months; we saw evidence of a meeting which took place in March 2017.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 24 May 2017

At our inspection on 3 August 2016, we rated the practice as requires improvement for providing safe services as the practice were not proactive in utilising opportunities from incidents to support learning and service improvement. Systems and processes to address some risks were not always sufficiently effective to ensure patients were kept safe. For example, risks relating to infection control, health and safety, disaster recovery, recruitment and staffing. These arrangements had significantly improved when we undertook a follow up inspection on 27 March 2017. For example:

  • Previously it was not clear from the documentation viewed that the practice was proactive in using incidents both positive and negative to support learning and service improvement. As part of the follow up inspection we saw lessons were being shared and actions had been taken following incidents to prevent the same thing happening.
  • During the previous inspection, staff were unable to provide records to demonstrate whether immunisations had been carried out for staff who handled specimens and staff were unable to provide evidence of completed training to enable non-clinical staff to carry out this role effectively. Documentation we viewed during the follow up inspection showed that staff had received immunity checks, vaccinations and had completed appropriate training.
  • From the personnel files we checked during the first inspection we saw that that proof of identification were not located in some files and Disclosure and Barring Service checks (DBS) had not been carried out for some staff prior to employment. During this inspection, we reviewed four personnel files and found that appropriate recruitment checks had been undertaken prior to employment.
  • Previously we saw that risk assessments associated with the premises’ were not practice specific or dated and fire safety check logs did not distinguish between fire alarm checks and fire drills. Documents we viewed as part of the follow up inspection such as risk assessments, the practice business continuity plan and the recording of fire alarm checks and fire drills had improved.

Effective

Good

Updated 24 May 2017

Caring

Good

Updated 24 May 2017

Responsive

Good

Updated 24 May 2017

Well-led

Good

Updated 24 May 2017

During the comprehensive inspection in April 2016, we rated the practice as requires improvement for well-led as some governance arrangements needed improving. These arrangements had significantly improved when we undertook a follow up inspection on 27 March 2017. For example:

  • At the August 2016 comprehensive inspection, some systems, processes and risks had not been established or operated effectively. Since the inspection, the practice strengthened their management of risks. For example, a full time practice manager was appointed, a designated health and safety lead had been established; policies were practice specific and a comprehensive business continuity plan for managing major incidents was in place.
  • Previously system for recording and learning from verbal complaints was not effective. When we carried out the follow up inspection, we saw that the practice kept a log of all complaints received. Meeting minuets’ showed that lessons were learned and actions had been taken following significant events and complaints.
  • During the comprehensive inspection, there were limited evidence that the practice had been proactive in obtaining feedback from patients, the public and staff.  Evidence of engagement with the patient participation group was limited. Documentation we viewed as part of the follow up inspection showed that the practice actively obtained feedback from patients and were working with the PPG. A number of internal surveys had been completed and shared with the PPG to assess patient satisfaction. 
Checks on specific services

People with long term conditions

Good

Updated 24 May 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 March 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Families, children and young people

Good

Updated 24 May 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 March 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Older people

Good

Updated 24 May 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 March 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

Working age people (including those recently retired and students)

Good

Updated 24 May 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 March 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

People experiencing poor mental health (including people with dementia)

Good

Updated 24 May 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 March 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

People whose circumstances may make them vulnerable

Good

Updated 24 May 2017

The provider had resolved the concerns for safety and well-led identified at our inspection on 27 March 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.