Background to this inspection
Updated
14 December 2016
Dr Mathurdas Dadhania’s (also known as St Georges Road Surgery) is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 1,800 patients living in the Stoke and surrounding areas of Coventry. A GMS contract is a standard nationally agreed contract used for general medical services providers.
The practice operates from a converted house from which all patients see the GP on the ground floor and nurse appointments are on the first floor. When patients have mobility problems the practice arranges appointments when the GP room is available on the ground floor. The practice population has a higher than average number of patients aged 20 to 40 years and lower than average number of patients aged 60 years onwards. National data indicates that the area is one that experiences moderate to high levels of deprivation. The practice population is multi-cultural with a mixed population predominantly white British patients with significant numbers of patients of Asian, Indian and eastern European origin.
Dr Mathurdas Dadhania is a single handed provider who employs a full time practice nurse, one full time receptionist, one part time reception /administrative assistant and a practice manager.
The practice is open Monday to Friday between 8.45am and 1pm, Monday and Friday afternoon from 3.30pm until 6.30pm and Wednesday from 3.30pm until 6pm. Extended hours appointments are available on Tuesdays from 6.30 until 7.30pm. When the surgery is closed, out of hours services are provided by Virgin Healthcare who can be contacted through NHS 111. A recorded message on the practice telephone line, advises patients of this.
Updated
14 December 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr M R Dadhania (known locally as St Georges Road Surgery) on 19 October 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 were aware of this and commented on the good daily communication that took place within the practice regarding any issues.
- Risks to patients 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.
- Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. We saw examples, of caring practice and patients commented on the caring service they received from the staff at the practice.
- 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 the GP and commented on the benefits of having an open surgery in the mornings for which they did not require an appointment. Urgent appointments available the same day and patients could access telephone consultations.
- The practice had adequate 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 should make improvement are:
- Amend the system in place for recording prescription allocation to show which room each batch was allocated and provide a clear audit trail.
- Introduce a log which clearly identifies what actions if any were taken as a result of MHRA safety alerts.
- Ensure infection control training takes place as planned
- Ensure regular fire drills are carried out.
- Explore ways of identifying more carers.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
People with long term conditions
Updated
14 December 2016
The practice is rated as good for the care of people with long-term conditions.
- The nurse had a lead role in chronic disease management and was additionally trained in diabetes management. The practice had an established system for recall management of long term conditions which staff reported worked effectively.
- We noted good achievement in diabetes management. For example, the percentage of patients with diabetes, on the register who had a blood pressure reading of 150/90 mmHg or less was 100%.
- Longer appointments and home visits were available when needed.
- All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care, such as the consultant in diabetes in secondary care who they had virtual access to using a specific system available to them.
Families, children and young people
Updated
14 December 2016
The practice is rated as good for the care of families, children and young people.
- There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
- Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
- The percentage of women aged 25 or over whose notes recorded that a cervical screening test had been performed was 87% which was higher than the CCG and national average of 81% and 82% respectively.
- Appointments were available outside of school hours and the premises were suitable for children and babies. Children were given priority when booking appointments and would always be seen.
- We saw positive examples of joint working with midwives and health visitors. The midwife carried out a clinic at the practice every fortnight.
Updated
14 December 2016
The practice is rated as good for the care of older people.
- The practice offered proactive, personalised care to meet the needs of the older people in its population.
- The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
- The practice manager contacted all older patients every two months to ensure they were well and all patients over 75 years were sent Christmas cards from the practice as they recognised that some patients did not have families to care for them.
- Older patients requesting evening appointments were prioritised and they would always be given an appointment.
Working age people (including those recently retired and students)
Updated
14 December 2016
The practice is rated as good for the care of working-age people (including those recently retired and students).
- The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. Patients had the option of telephone appointments, open surgery in the morning or appointments in the afternoon as well as extended hours appointments on Tuesdays.
- The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
People experiencing poor mental health (including people with dementia)
Updated
14 December 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
- 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was above the CCG and national average of 81% and 83% respectively.
- 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in their record, in the preceding 12 months, which had been agreed between individuals, their family and/or carers as appropriate. This was above the CCG and national averages of 86% and 89% respectively.
- The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. The GP had telephone access to a GP liaison consultant and the mental health crisis team.
- The practice carried out advance care planning for patients with dementia.
- The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
- The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
- Staff had a good understanding of how to support patients with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
14 December 2016
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
- The practice held a register of patients living in vulnerable circumstances including those with a learning disability.
- The practice offered longer appointments for patients with a learning disability.
- The practice regularly worked with other health care professionals in the case management of vulnerable patients.
- The practice informed vulnerable patients about how to access various support groups and voluntary organisations and we saw information leaflets available in the waiting areas to for patients to access.
- Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.