Letter from the Chief Inspector of General Practice

At our previous comprehensive inspection at Dr Jitendrakumar Trivedi, more commonly known as Shreeji Medical Centre in Slough, Berkshire on 22 June 2016 we found a breach of regulations relating to the provision of safe services. The overall rating for the practice was good. Specifically, the practice was rated requires improvement for the provision of safe services, outstanding for the provision of effective services and good for the provision of caring, responsive and well-led services. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Dr Jitendrakumar Trivedi on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 5 April 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection in June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

We found the practice had made improvements since our last inspection. Using information provided by the practice we found the practice was now meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, caring, responsive and well led services. The practice remains rated as outstanding for the provision of effective services.

Our key findings were as follows:

• The practice had introduced a system for tracking and monitoring the use of blank prescription forms and pads. This system was now in line with national guidance. Completed actions included the installation of printer locks to prevent unauthorised access to blank prescription forms.

• The practice had reviewed existing arrangements regarding the awareness of consent. We saw the consent policy had been shared and awareness training discussed in staff meetings which were attended by non-clinical and clinical staff including regular and locum staff. Furthermore, the practice had arranged full access to all the consent correspondence to be accessible to all staff including within the revised locum induction pack, which must be read prior to working at the practice.

• The practice had established and was now operating safe systems to assess, manage and mitigate the risks identified relating to fire safety. This included documented fire evacuation drills and a review of evacuation procedures.

• Further steps had been taken steps to increase the number of identified patients with caring responsibilities within the practice population. The practice had identified 27 patients, who were also a carer; this was an increase from 11 identified carers at the June 2016 inspection and amounted to approximately 0.5% of the practice list. We saw each month the practice was identifying more carers and advising them of the various avenues of support available from the practice. To further increase the identification of carers, the practice actively promoted carers awareness through practice videos (including videos in different languages spoken within the community) alongside posters and leaflets available in the waiting room. The practice had held further carers meetings where information was shared about resources for carers, including financial support and healthcare resources.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

When we visited the practice on 5 December 2013, we found patient confidentiality and dignity was not always maintained. We found patients who used the service were not fully protected from the risk of abuse, because the provider had not taken all reasonable steps to identify the possibility of abuse and prevent abuse from happening. We received an action plan which set out what actions were to be taken, to achieve compliance.

During this inspection we found the practice had taken effective action and achieved compliance.

We found the practice now had robust systems in place to maintain patient confidentiality. Staff we spoke with knew about confidentiality and demonstrated that they understood patient privacy. This ensured the practice had put systems in place to ensure patients gave consent before interpreters were used.

Patients who used the service were protected from the risk of abuse. Staff members had access to up to date adult and children safeguarding policies and procedures. We found criminal record checks via the Disclosure and Barring Service (DBS) were in place for all appropriate staff. The practice had ensured the chaperone service was easily accessible and clearly advertised to patients.

We spoke with five patients who used the service. They told us they were treated with care and respect. We found staff spoke with people in a professional and friendly manner both on the telephone and in person at the practice. One patient told us “The staff are very respectful and polite.” Another patient told us “I find the staff very kind and caring.” A third patient told us “I have no issues with the staff here; they try their best and are always very helpful.”

Patients told us they were satisfied with the care and treatment they received from the GP’s and the nurses. One patient told us “I have been with the surgery for a long time, the Doctors are generally good.” Another patient said “Once I am seen then I have no issues…I have enough time to tell the Doctor why I am here and they then tell me the options available.” A third patient told us “The staff are pleasant… generally I get a good service from the surgery.”

Patients told us they felt safe and confident with the care provided at the practice. One patient told us “I have no concerns about safety here.” Another patient told us “I feel safe.”

Patient's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. However, patient confidentiality and dignity was not always maintained.

We found patients who used the service were not fully protected from the risk of abuse, because the provider had not taken all reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Patients were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. However, some staff had not received regular supervision and appraisal.

We found the provider had effective systems in place to regularly assess and monitor the quality of service that patient's received.

Letter from the Chief Inspector of General Practice

At our previous comprehensive inspection at Dr Jitendrakumar Trivedi, more commonly known as Shreeji Medical Centre in Slough, Berkshire on 22 June 2016 we found a breach of regulations relating to the provision of safe services. The overall rating for the practice was good. Specifically, the practice was rated requires improvement for the provision of safe services, outstanding for the provision of effective services and good for the provision of caring, responsive and well-led services. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Dr Jitendrakumar Trivedi on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 5 April 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection in June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

We found the practice had made improvements since our last inspection. Using information provided by the practice we found the practice was now meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, caring, responsive and well led services. The practice remains rated as outstanding for the provision of effective services.

Our key findings were as follows:

• The practice had introduced a system for tracking and monitoring the use of blank prescription forms and pads. This system was now in line with national guidance. Completed actions included the installation of printer locks to prevent unauthorised access to blank prescription forms.

• The practice had reviewed existing arrangements regarding the awareness of consent. We saw the consent policy had been shared and awareness training discussed in staff meetings which were attended by non-clinical and clinical staff including regular and locum staff. Furthermore, the practice had arranged full access to all the consent correspondence to be accessible to all staff including within the revised locum induction pack, which must be read prior to working at the practice.

• The practice had established and was now operating safe systems to assess, manage and mitigate the risks identified relating to fire safety. This included documented fire evacuation drills and a review of evacuation procedures.

• Further steps had been taken steps to increase the number of identified patients with caring responsibilities within the practice population. The practice had identified 27 patients, who were also a carer; this was an increase from 11 identified carers at the June 2016 inspection and amounted to approximately 0.5% of the practice list. We saw each month the practice was identifying more carers and advising them of the various avenues of support available from the practice. To further increase the identification of carers, the practice actively promoted carers awareness through practice videos (including videos in different languages spoken within the community) alongside posters and leaflets available in the waiting room. The practice had held further carers meetings where information was shared about resources for carers, including financial support and healthcare resources.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice