Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr T Abela & Partners on 20 February 2017. The overall rating for the practice was good. Safe, effective, caring and well-led were rated as good and responsive was rated requires improvement. The full comprehensive report on the February 2017 inspection can be found by selecting the ‘all reports’ link for Dr T Abela & Partners on our website at www.cqc.org.uk.

This inspection was a focused desk-based inspection carried out on 26 October 2017 to confirm whether the practice had carried out their plan to meet the legal requirements in relation to the issues that we identified in our previous inspection on 20 February 2017. This report covers our findings in relation to those requirements since our last inspection.

Overall, the practice remains rated as good and responsive continues to be rated as requires improvement.

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

• Feedback from the GP patient survey showed that patients continued to experience difficulty in accessing appointments.
• Changes had been made to the appointment system with a view to improving feedback.
• The patient participation group were yet to meet this year. A meeting had been scheduled to take place in November 2017.
• The practice advertised the patient participation group meeting on its website in in the waiting room with a view to attracting new members.
• The practice had identified 57 patients as carers. This amounted to 0.4% of the practice list.

The practice should:

• Continue to identify and support patients who are carers.
• Continue to encourage the development of an active patient participation group.
• Monitor, review and improve patient satisfaction with regards to access.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr T Abela & Partners also known as Chafford Hundred Medical Centre on 5 May 2016. At that time, the overall rating for the practice was requires improvement. The full comprehensive report of the 5 May 2016 inspection can be found by selecting the ‘all reports’ link for Dr T Abela & Partners on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 20 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 20 February 2017. So that we could provide a rating for the practice, we inspected all domains and key questions. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• Improvements had been made and patients taking high risk medicines were being reviewed and monitored.
• There continued to be issues highlighted in the GP survey in relation to getting through the practice by phone and seeing a preferred GP, but actions had been taken to improve feedback.
• Blank prescription forms were now being monitored.
• Pathology results effectively recorded actions taken.
• An additional six patients had been identified who were carers since our last inspection although this still meant that only 0.3% of the practice population had been identified as carers.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients at the premises were assessed and well managed.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a commitment to learning and sharing information.
• Information about services and how to complain was available and easy to understand.
• There was a clear leadership structure and staff felt supported by management.
• The practice proactively sought feedback from patients, which it acted on.

The areas where the provider should make improvements are:

• Identify more patients who also act as carers.
• Take steps to promote and encourage an active patient participation group.
• Continue to monitor the actions taken to improve patient satisfaction in relation to the appointments system and implement further changes when required.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Abela and Partners on 3 May 2016. Overall the practice is rated as requires improvement.

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

• Significant events were routinely discussed at a weekly clinical meeting. Patients were informed of the outcome of the investigation and given an apology, where appropriate.

• Staff had received training on safeguarding children and vulnerable adults relevant to their role. Staff were kept informed of wider safeguarding risks, for example in relation to FGM (female genital mutilation).

• Each partner had a lead role for each area of QOF. The practice was not an outlier for any QOF (or other national) clinical targets.

• There was no robust system in place to ensure that patients on high risk medicines were receiving regular blood tests.

• Comment cards highlighted that staff were respectful and considerate to patients during difficult times in their lives.

• Information about services and how to complain was available and easy to understand.
• Patients said they found it difficult to make an appointment with a named GP. Some patients were not satisfied with the practice’s opening hours.
• Effective steps had not been taken to improve appointment access in response to patient feedback.
• There were weekly clinics held at the practice by the health visitor, midwife and the community counsellor.

The areas where the provider must make improvements are:

• Review and monitor patients taking high risk medicines.

• Take steps to improve access and respond to the issues raised in the National GP Patient Survey.

In addition the provider should:

• Monitor and track the use of blank prescription forms.

• Ensure the records of pathology results effectively record the action taken.

• Take steps to identify more patients who are carers and provide them with appropriate support and health checks where relevant.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice