This practice is rated as Requires Improvement overall.

The key questions at this inspection 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

We carried out an announced first comprehensive inspection at Dr Shakarchi’s Practice on 6 November 2018.

At this inspection we found:

• Although risks to patients were assessed, the systems to address these risks were not implemented well enough to ensure patients were kept safe. For example, we found the management of infection prevention and control, emergency medicines, medical emergencies, patient clinical records, safety netting of two-week wait referrals and cervical screening required improvement.
• There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns.
• There was a system in place for reporting and recording significant events and we saw the practice had learned from those recorded. However, the process was not consistent.
• Clinical staff we spoke with demonstrated they delivered care and treatment in line with current legislation, standards and guidance. However, the practice did not have a formal process in place for cascading new guidance to all clinical staff.
• The was evidence of quality improvement to review and monitor the effectiveness and appropriateness of the care. However, there was no formal process to identify clinical audits or no programme of continuous audits.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients told us they found the appointment system easy to use and reported they were able to access care when they needed it. Some of the national GP patient survey results for access were above local and national averages.
• There was a clear leadership structure and staff felt supported by management.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider must make improvements are:

• 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:

• Continue to monitor patient outcomes in relation to the cervical screening programme and the child immunisation programme.
• Continue to identify the number of carers registered at the practice so they can be offered further help and support.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.