Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Goodmayes Medical Centre on 9 October 2015. At that time we found the practice was breaching legal requirements in relation to safe care and treatment, and, good governance. Specifically:

• The practice did not have adequate procedures in place to protect patients and staff from the risk of infection.
• We also found the practice was not ensuring that patients had reasonable access to the service.

The previous comprehensive inspection report can be found by selecting the ‘all reports’ link for Dr A K & S Shah on our website at www.cqc.org.uk.

Following our inspection in October 2015, the practice wrote to us with details of the actions they would take to meet the legal requirements.

We undertook this focused inspection to check that the practice had followed their plan and to confirm that the practice was now meeting the legal requirements. This inspection included a visit to the practice on 18 October 2016. This report covers our findings from this focused inspection.

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

• The practice was providing safe services. We have rated the practice as good for providing safe care. The practice had improved the systems in place to protect patients and staff from the risk of infection.
• The practice was providing responsive services. We have rated the practice as good for providing responsive care. The practice had taken some steps to improve access to appointments and this was reflected in improved patient feedback.

The areas where the provider should make improvement are:

• There is scope to further improve access to the service, for example,  the ease of getting through to the practice by telephone.
• The practice should assess whether it has sufficient clinical capacity for example through a systematic appointments audit.
• The practice should also review any outstanding areas for improvement identified at our previous inspection.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr A K & S Shah on 9 October 2015. Overall the practice is rated as requires improvement.

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

• There was an open approach to safety and a system in place for reporting and recording significant events.
• Most risks to patients were assessed and well managed. The practice needs to improve on infection control.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• There was mixed feedback from patients about whether they were treated with compassion, dignity and respect and whether they were involved in decisions about their treatment. The 2015 National GP Patient Survey results for the practice were poor. In contrast, comments we received from patients and the Patient Participation Group were very positive about these aspects of the service.
• Patients said it was difficult to make appointments and this was reflected in the practice’s 2015 National GP Patient Survey results.
• Information about services and how to complain was available and easy to understand.
• The practice had suitable premises 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 areas where the provider must make improvement are:

• The practice must ensure systems are in place to protect patients and staff from the risk of acquired infection. The practice should ensure that its infection control and related policies are up to date and reflect current requirements.

• The practice must ensure that the service is accessible to patients in need of primary health care and the appointment system is fit for purpose.

The areas where the provider should make improvement are:

• The practice should encourage the positive reporting of events and incidents to provide opportunities to learn and improve patient safety.

• The practice should have a written locum pack for locum doctors to refer to.

• The practice should review whether there is a need for staff to have training on the Mental Capacity Act 2005. Staff were not fully confident about their obligations under the Act.

• The practice should ensure that policies are reviewed and updated periodically to ensure they reflect current practice.

• Patient experience as reported by the 2015 National Patient GP survey was poor. The practice should further investigate the reasons for its poor performance as this may indicate areas for improvement.

• The practice did not provide written information, for example, its practice leaflet, in other languages.

• The practice did not have its own website.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People expressed their views and were involved in making decisions about their care and treatment. They said the doctors explained treatment and tests to them in a way they could understand and they were able to give their own views. One comment was "I like (my doctor) because (they'll) discuss my care and treatment with me. It's very good."

People's needs were assessed and care and treatment was planned and delivered in line with their individual treatment plan. People's comments included "I feel confident about my doctor", "(they've) been very good" and "I believe they are genuine and consistent in their care."

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People said they felt safe using the service. One person said "I feel very safe, no problems."

There were effective recruitment and selection processes in place. Non-clinical staff did not undergo Disclosure and Barring Service (DBS) checks. We told the provider they should be able to show that a risk assessment has been undertaken, especially where they have decided not to undertake a check.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. There was evidence that learning from incidents / investigations took place and appropriate changes were implemented.