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Care Quality Commission

Updated 27 December 2017

Letter from the Chief Inspector of General Practice

This practice is rated as Requires improvement overall. (Previous inspection October 2015 – Good overall, Requires improvement for Safe).

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Requires improvement

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Requires improvement

People with long-term conditions – Requires improvement

Families, children and young people – Requires improvement

Working age people (including those recently retired and students – Requires improvement

People whose circumstances may make them vulnerable – Requires improvement

People experiencing poor mental health (including people with dementia) - Requires improvement

We carried out an announced comprehensive inspection at Drs Fazil, Buckley & Raghwani - Fieldhouse Medical Group on 13 November 2017 as part of our inspection programme.

At this inspection we found:

    • The practice had some systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
    • The practice did not have a system to record when action was taken following the receipt of national safety alerts.
    • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
    • We found there was a lack of evidence of records of mandatory training such as safeguarding, basic life support and infection control.
    • Staff involved and treated patients with compassion, kindness, dignity and respect.
    • There was a strong focus on continuous learning and improvement at all levels of the organisation.
    • The practice understood the needs of its population and tailored services in response to those needs. For example extended opening hours, online services such as repeat prescription requests and advanced booking of appointments.

The areas where the provider must make improvements are:

    • Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
    • 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 areas where the provider should make improvements are:

    • Reception staff should receive awareness training and written guidance about sepsis signs and recognising deteriorating patients.
    • Continue with efforts to review and monitor processes for QOF; auditing areas of high exception reporting.
    • The practice should undertake a formal risk assessment to ensure the emergency drugs are appropriate for the activities provided by the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

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