Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the surgery of Dr Haffizullah Bhat on 28 July 2016. Overall the practice was rated as good; however a breach of the legal requirements was found which resulted in the practice being as rated as requires improvement for providing safe services.

Following on from the inspection the practice provided us with an action plan detailing evidence of the actions they had taken to meet the standards relating to providing safe services.

We undertook a desk based review on 27 March 2017 and visited the practice on 28 March 2017. This was to review in detail the information the practice had sent to us and to confirm that the practice were now meeting the relevant standards of care.

A full comprehensive report which followed the inspection on 28 July 2016 can be found by selecting ‘all reports’ link for Dr Haffizullah Bhat on our website at www.cqc.org.uk.

The practice is now rated as good for providing safe services.

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

• The monitoring of refrigerator temperatures was now in place.
• The cold chain was maintained and staff were appropriately trained.
• A review of the policy and of emergency drugs kept in the practice and used for home visits had been amended.
• Clinical waste was now appropriately recorded and disposed of.
• The complaints policy had been updated and letters to patients informed them of the services of the ombudsman if they were not satisfied with the outcome.
• The complaints policy had been discussed with the whole staff group and they were aware of their duties in relation to this.

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 Haffizullah Bhat on 28 July 2016. The practice is rated as requires improvement for safety. 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.
• Not all risks to patients were assessed and well managed. For example, Staff were not familiar with how to operate the temperature gauge on the vaccine fridge. The temperature of the vaccine fridge had exceeded the accepted minimum and maximum temperature of the accepted range for the safe storage of vaccines.
• Emergency medicines were not easily accessible. We noted that one of the emergency medicines had expired. The practice did not stock some emergency medicines and this had not been risk assessed.
• 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.
• 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 found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a vision to deliver high quality care, promote good outcomes for patients and treat all patients fairly and equally. Staff were clear about the vision and their responsibilities in relation to it.
• 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 must make improvement are:

• The practice must ensure staff understand and follow practice policies and procedures for the management of the vaccine fridge and the cold chain.
• Review the arrangements for the storage and develop systems to monitor expiry dates for emergency medicines and equipment. Carry out a risk assessment to identify a list of medicines that are suitable for the practice to stock and provide emergency oxygen at the practice.

The areas where the provider should make improvement are:

• Review the labelling arrangements for clinical waste bags to be able to identify the source of the waste in line with current legislation and guidance.
• Review and update the information in the complaints policy and procedure about how to take action if patients are not satisfied with how the complaint is dealt with. Discuss the complaints procedure with staff to ensure they are familiar with practice procedures.
• The practice should continue to monitor their QOF exception reporting rates in line with their exception reporting policy to ensure that patients are only excepted when there is justification for doing so.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

As part of our inspection we spoke with two people who used the service, four staff members; including one doctor, the practice manager and reception staff. These are some of the things people told us:

"The practice listen to what people say."

"I find the practice very good."

We found care and treatment was planned and delivered in a way that ensured people’s safety and welfare.

Staff had received abuse awareness training and procedures were in place to respond appropriately to any allegation of abuse.

During our inspection we found the practice did not have effective recruitment and selection processes in place. This means the practice did not have the necessary checks and risk assessments in place to ensure people were protected from potentially unsuitable staff.

People had their comments and complaints listened to and where appropriate action had been taken.

We reviewed the information available to us about Dr Haffizullah Bhat on 4 June 2019. 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.