This practice is rated as requires improvement overall. (Previous rating 10/2015 – Good)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Requires improvement

We carried out an announced comprehensive inspection at Dr Shapiro & Partners on 19 June 2018 as part of our inspection programme.

At this inspection we found:

• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice had some systems for appropriate and safe handling of medicines. However, improvements in monitoring fridge temperatures, patients on lithium, safety alerts and uncollected repeat prescriptions were required.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Although, clinical audit was not used to assess the quality of care and outcomes for patients.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Most patients found the appointment system easy to use and could access care when they needed it, although some patients reported difficulties accessing the practice via telephone and getting an appointment with the GP of their choice. The practice was acting to improve telephone access.
• The practice reviewed data from the Friends and Family test. However, they did not proactively engage and involve patients and the patient participation group to support good quality sustainable services.
• There was a focus on continuous learning and improvement at all levels of the organisation. However, there was a lack of management oversight in managing risks relating to medicines management.

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

• Review and improve clinical staff access to information on patients who may be at risk.
• Improve the security of blank prescriptions stored in consulting rooms.
• Review and improve reception staff training for their role in the management of patients with severe infections, and clinical staff training in consent to care and treatment.
• Implement continuous clinical audit to assess and monitor the quality of care and outcomes for patients.
• Develop supporting business plans to achieve practice priorities and share the vision with staff.

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 Shapiro and Partners (also known as Wood Lane Medical Centre) on 28 October 2015. 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. All significant events and incidents were discussed at practice meetings, although we found some clinical incidents were not always recorded and investigated as a significant event.
• Risks to patients were assessed and well managed.
• 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.

• Recruitment checks had been carried out prior to employment, although we found that the GP partners had not received a disclosure and barring service check (DBS).

• 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.
• Most patients said they found it easy to make an appointment with a named GP and that 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.
• 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.

In addition the provider should:

• Complete annual infection prevention and control audits.

• Carry out a legionella risk assessment.

• Review national guidance relating to annual basic life support training for non-clinical staff.

• Review protocols for including patient consent in the patient record.

• Advertise that translation services are available to patients on request.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice