Parkview Surgery Edgware in Edgware is a Doctors/GP specialising in the provision of services relating to diagnostic and screening procedures, maternity and midwifery services, services for everyone, surgical procedures and treatment of disease, disorder or injury. The last inspection date here was 19th March 2018
Parkview Surgery Edgware is managed by Parkview Surgery Edgware.
Contact Details:
Address:
Parkview Surgery Edgware 36 Cressingham Road Edgware HA8 0RW United Kingdom
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Parkview Surgery on 21 June and 5 July 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the June and July 2017 inspection can be found by selecting the ‘all reports’ link for Dr T Ganesh and Dr S Shanmugaratnam on our website at www.cqc.org.uk.
This inspection was an announced focused inspection carried out on 26 January 2018 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 21 June and 5 July 2017. 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:
Staff were aware of their responsibilities in relation to information governance, and had undertaken information governance training.
New systems and processes had been developed to improve record keeping within the practice to ensure that a complete and contemporaneous record is kept in respect of each service user in an accessible way. Staff had also received record keeping training.
New processes had been put in place to improve areas where patient outcomes were below average, in particular in relation to the proportion of patients excepted from the Quality and Outcomes Framework and the uptake of cancer screening and childhood immunisation programmes.
The minutes of internal and external meetings were being taken consistently.
The significant events process had been reviewed to ensure significant events were promptly recorded.
The process for checking uncollected prescriptions had been reviewed and a new prescribing policy had been developed.
Care plans developed for those patients that required these were given to patients to take home for their information following their consultations.
The practice had reviewed areas where patients rated the service below average as part of the NHS GP Patient Survey and had set up a new Patient Participation Group to optimise patient feedback.
The interpreting service was advertised to patients at reception and via posters and leaflets.
The allocation of tasks and responsibilities within the practice had been reviewed to ensure that all staff were clear about their roles
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr T Ganesh and Dr S Shanmugaratnam (also known as Parkview Surgery) on 11 May 2016. 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.
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.
However, systems were not in place to monitor patients taking specific medicines prescribed for those with mental health issues.
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. Improvements were made to the quality of care as a result of complaints and concerns.
Patients said they found it easy to make an appointment with a named GP and 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.
The areas where the provider must make improvement are:
Establishing a system of regular audits, reviews of patient medicines and care plans which are updated and recorded on patient notes.
To conduct risk assessments or obtain DBS checks for non-clinical staff who conduct chaperoning duties.
The areas where the provider should make improvement are:
Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is available to them.
Establish processes to ensure computerised records have all patient information received by the practice is attached in a timely manner.
To put in place an action plan to address suggested improvements following Infection Control Audit.
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection of Dr T Ganesh and Dr S Shanmugaratnam (also known as Parkview Surgery) on 11 May 2016. A breach of legal requirements was found in relation to regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We undertook an announced focussed inspection on 21 June 2017 to check that the practice now met the legal requirements. During this inspection we found that some areas had been addressed, but we found some further areas of concern which required further investigation. Therefore, the decision was made to extend the focussed inspection to a full comprehensive inspection, and we returned to the practice for an announced visit on 5 July 2017 in order to consider the areas which had not been covered during the focussed inspection and to look in further detail into the areas of concern we had noted. This report covers our findings from the inspections on 21 June 2017 and 5 July 2017. You can read the report from the initial comprehensive inspection by selecting the ‘all reports’ link for Dr T Ganesh and Dr S Shanmugaratnam on our website at www.cqc.org.uk.
Overall the practice was rated as good following the initial comprehensive inspection on 11 May 2016. They were rated as requires improvement for providing safe services. Following the re- inspection we rated the practice as good for providing safe, caring and responsive services, and requires improvement for being effective and well led resulting in an overall rating of requires improvement.
Our key findings were as follows:
There was an open and transparent approach to safety and a system in place for reporting and recording significant events; however, there could sometimes be a delay in incidents being formally recorded.
The practice had systems to minimise risks to patient safety; however, those relating to the recording of patient information and the management of uncollected prescriptions needed improvement.
Patient information was not always recorded and stored in a way that ensured that effective care could be provided, and staff had not received training in information governance.
Data relating to the practice’s management of patients with long-term conditions was mixed, and in some areas the practice had excepted a high proportion of eligible patients. The practice also had a below average uptake amongst its patients for cancer screening and childhood immunisation programmes.
Results from the national GP patient survey were mixed, with the practice scoring below average in some areas relating to the service provided by doctors and nurses.
Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
The practice had good facilities and was well equipped to treat patients and meet their needs.
There was a documented leadership structure and staff felt supported by management; however, in some areas, such as infection prevention and control, there was a lack of clarity about who was responsible. The practice met occasionally as a team, but these meetings were not held consistently and minutes were not always taken.
The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
There were areas of practice where the provider needs to make improvements.
Importantly, the provider must:
Ensure that staff are aware of their responsibilities in relation to information governance, and that a complete and contemporaneous record is kept in respect of each service user in an accessible way.
Review, and put in place measures to improve, areas where patient outcomes are below average, in particular in relation to the proportion of patients excepted from the Quality and Outcomes Framework and the uptake of cancer screening and childhood immunisation programmes.
Ensure that minutes of internal meetings are taken consistently.
In addition the provider should:
Review the significant events process to ensure prompt recording.
Review the process for checking uncollected prescriptions so it is consistently implemented across both sites.
Consider whether it is appropriate to provide patients with a copy of their care plan.
Review and address areas where patients have rated the service below average as part of the NHS GP Patient Survey.
Ensure that patients are aware that translation services are available.
Review the allocation of tasks and responsibilities within the practice to ensure that all staff are clear about their roles.
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