The Care Quality Commission
  • Doctor
  • GP practice

Dr Khong & Partners

Overall: Good read more about inspection ratings

Pasley Road Health Centre, Pasley Road, Leicester, Leicestershire, LE2 9BU (0116) 295 8430

Provided and run by:
Dr Khong & Partners

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Dr Khong & Partners on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Dr Khong & Partners, you can give feedback on this service.

22 January 2020

During an annual regulatory review

We reviewed the information available to us about Dr Khong & Partners on 22 January 2020. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

22 December 2016

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at Dr Khong & Partners on 22 December 2016. Overall the practice is rated as good.

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

  • The practice had reviewed their significant event policy and lessons learnt were discussed at practice meetings.

  • The practice had introduced audit cycles in relation to alerts published by the Medicines and Healthcare products Regulatory Agency (MHRA).

  • Electrical equipment had been tested and mainitained.

  • Appropriate training had been completed to ensure the practice could offer minor surgery services.

  • The practice had implemented an organisational chart which clearly identified who the clinical lead was, including reporting responsibilities.

  • Minutes of practice meetings were detailed and evidenced what was discussed and what action was to be taken, by whom, if any.

  • A patient participation group (PPG) meeting was held in September 2016. The group discussed and agreed what the next steps were for the group and what information was available for patients to make them aware of the PPG.

  • Policies and procedures had been reviewed to ensure they were practice specific.

  • Appropriate training had been completed to ensure the practice could offer minor surgery services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

17 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Khong & Partners on 17 May 2016. Overall the practice is rated as requires improvement.

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However we found that incidents had occurred that had not been investigated and reported as such as they were non clinical which had not been identified as a significant event.
  • Risks to patients were assessed and well managed for the overall building however practice specific risks had not been identified and assessed. For example issues identified in infection control audit.
  • Although some audits had been carried out, we saw no evidence that audits were driving improvements to patient outcomes.
  • The practice had a number of policies and procedures to govern activity, but some were overdue a review and were not all specific to the practice.
  • Safety alerts were received and forwarded to staff in the practice however not all prompted audits to ensure that patients were identified that could be at risk.
  • Electrical equipment had not been tested since 2013.
  • Data showed patient outcomes were high compared to the national average.
  • Patients said they were treated with compassion, dignity and respect.
  • Patients were able to get an appointment on the day and were happy with the appointment system and availability.

  • Staff said they felt respected, valued and supported, particularly by the partners in the practice.

The areas where the provider must make improvements are:

  • Introduce robust processes for reporting, recording, acting on and monitoring significant events, incidents and near misses including non-clinical.
  • Carry out clinical audits and re-audits to improve patient outcomes especially those relating to safety alerts.
  • Ensure that staff are trained and competent prior to providing any services.

In addition the provider should:

  • Review and update procedures and guidance to make sure they are specific to the practice.
  • The business continuity plan should be updated to include contact numbers for suppliers such as Gas, Electricity and Water.
  • Implement formal governance arrangements systems for assessing and monitoring risks including the monitoring of equipment testing.
  • Multi-disciplinary team meetings should be regular and documented.
  • Carers information should be available for patients to access and identification of carers should be proactive.
  • Ensure that the patient participation is active and in place.
  • Clarify the leadership structure and ensure there is leadership capacity to deliver all improvements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice