We carried out an announced comprehensive inspection at Dr R Mapara & Partners on 28 November 2018 as part of our inspection programme.

At the last inspection in April 2015 we rated the practice as good overall.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

At this inspection we found:

• People who used the service were protected from avoidable harm and abuse.
• Patients’ needs were met by the way in which services were organised and delivered.
• The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.
• Feedback from patients was consistently positive and was higher than local and national averages.
• There was a strong person-centred culture.
• Staff we spoke with were committed to providing high quality care for patients and demonstrated a very caring approach to patient care, at times going above and beyond to meet the needs of more vulnerable patients.
• The practice worked closely with people who lived in a care setting and had strong, multi-disciplinary links to ensure that patients who were frail had advanced care plans in place which allowed them to choose their care and treatment.
• The practice worked closely with Community Navigators to assist patients in accessing local services within their community. They worked with vulnerable patients to assist them in ways which were not limited to their care and treatment needs at the practice in order to enable them to live healthily and more positive lives.
• There was a patient liaison manager at the practice who provided support for patients when they needed it. Staff were easily accessible and demonstrated a very compassionate and caring approach to patient care.
• The service worked closely with the local substance misuse service and met with them regularly. The lead GP worked with substance misuse patients within the practice and had strong links with local community support for this vulnerable group. Patients with no fixed abode were seen at the practice.

We rated the practice as requires improvement for providing safe services because:

• The practice had not reviewed the prescribing of a specific medicine in line with evidence-based guidance so that care and treatment was delivered safely.
• The system for storing blank prescriptions needed to be reviewed. The provider took action to address this following our inspection.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure that care and treatment is provided in a safe way to patients.

There were some areas where the provider should make improvements. These are:

• Review the system for storing prescriptions overnight so that these are safe.
• Ensure all staff were adequately trained in relation to identifying signs of sepsis.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

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 K Hodge and Partners on 29 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for older people, people with long term conditions, families with young children, working age people, those whose circumstances make them vulnerable and those suffering with mental health problems.

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Policies and procedures were robust and embedded in the practice giving guidance to staff to carry out their roles.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Feedback from patient was positive. 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.
• Staff were supported with training and development.
• The practice had good facilities 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.

There was an area of practice where the provider needs to make improvements.

The provider should:

• Complete the actions highlighted from the recent infection control audit.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice