The Care Quality Commission
  • Doctor
  • GP practice

Dr Salam J Farhan Also known as Partington Central Surgery

Overall: Inadequate read more about inspection ratings

Partington Health Centre, Central Road, Partington, Manchester, Greater Manchester, M31 4FY (0161) 775 7032

Provided and run by:
Dr Salam J Farhan

All Inspections

9 November 2023

During a routine inspection

We carried out an announced comprehensive at Dr Salam J Farhan (Partington Central Surgery) on 29 November 2023. Overall, the practice is rated as Inadequate.

Safe - Inadequate

Effective - Inadequate

Caring - Good

Responsive - Requires Improvement

Well-led - Inadequate

The practice was last inspected in 2018 when they were found to be good following a rating of requires improvement.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr Salam J Farhan on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection due to an aged rating as well as in response to other information we held about the practice.

Key questions inspected

  • Safe
  • Effective
  • Caring
  • Responsive
  • Well Led

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included

  • Conducting staff interviews using team meetings.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A shorter site visit.
  • Reviewing feedback from staff questionnaires
  • Speaking to staff

Our findings

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We rated the provider as inadequate for providing safe services. This was because :-

  • The provider did not offer care in a way that kept patients safe and protected them from avoidable harm.
  • Safeguarding was not given sufficient priority.
  • Clinical and non-clinical staff working at the practice had not undertaken all necessary training to support their roles.
  • Staff had not all undertaking mandatory training.
  • Recruitment processes did not evidence that staff were safely employed.
  • Risk assessments were not undertaken.
  • The arrangements for managing medicines did not always keep people safe.
  • Significant events were not always discussed, shared and learned from sufficiently or appropriately.

We rated the provider as inadequate for providing effective services. This was because :-

  • Patients did not always receive effective care and treatment that met their needs.
  • Care and treatment was not always delivered in line with current legislation, standards and evidence based guidance supported by clear pathways and tools.
  • Patients with long term conditions did not always receive reviews that included all elements to sustain good outcomes.
  • Patients were not always followed up in a timely manner when necessary.
  • Quality improvement activity did not evidence improvement.
  • There was no clinical audit or monitoring to ensure the service was sufficient and safe to meet the needs of its population.
  • There was no evidence that staff were trained, supervised or appraised to appropriate levels.

We rated the provider as Good for providing caring services. This was because :-

  • Staff told us they dealt with patients with kindness and respect and said they involved them in decisions about their care as much as possible and although patient feedback was mixed there was substantial positive feedback from patients.

We rated the provider as Good for providing responsive services. This was because :-

  • Feedback from the GP patient survey evidenced that patients could access care and treatment in a timely way.
  • Feedback from NHS choices was positive.

We rated the provider as inadequate for providing well led services. This was because :-

  • The way the practice was led and managed did not promote the delivery of high-quality, person-centre care.
  • The overall governance arrangements were not effective.
  • Arrangements for identifying, recording and managing risks, issues and mitigating actions were not effective.
  • Structures, processes and systems for accountability were not clearly set out or understood by staff.

The provider should:

  • Improve the uptake of all child immunisations.
  • Improve the uptake of cervical screening.

We found breaches of regulations. The provider must:

  • 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.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration. Special measures will give people who use the service the reassurance that the care they get should improve.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care

14/08/2018

During a routine inspection

This practice is rated as Good overall. (Previous rating 20/02/2018 Requires Improvement)

At the February 2018 inspection the key questions were rated as:

Are services safe? Requires Improvement

Are services effective? – Require Improvement

Are services caring? – Requires improvement

Are services responsive? – Requires improvement

Are services well-led? – Requires Improvement

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Dr Salam J Farhan, also known as Partington Central Surgery on 14 August 2018. This was a full comprehensive inspection carried out to check that the practice had made the required improvements.

At this inspection we found:

  • Safety concerns were now consistently identified and addressed in a timely manner. Reviews and learning from incidents were now thorough and there was a clear system 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 routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
  • There was evidence that audit was driving improvement and complaints were now used as an opportunity to learn and approve.
  • Staff involved patients and treated them with compassion, kindness, dignity and respect.
  • Patients found the appointment system easy to use and reported that they could access care when they needed it. Fifteen-minute appointments were provided to all patients.
  • There was evidence of sustained improvement and a strong focus on continuous learning at all levels of the organisation.

The areas where the provider should continue to improve are:

  • Improve the processes for uncollected prescriptions and checks on children who have missed hospital appointments to ensure they are failsafe.
  • Refine the process around incident review, in particular about who is taking action.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

20 February 2018

During a routine inspection

This practice is rated as Requires Improvement overall. (Previous inspection report published 23/03/2016 – Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Requires Improvement

Are services responsive? – Requires Improvement

Are services well-led? - Requires Improvement

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Requires Improvement

People with long-term conditions – Requires Improvement

Families, children and young people – Requires Improvement

Working age people (including those recently retired and students – Requires Improvement

People whose circumstances may make them vulnerable – Requires Improvement

People experiencing poor mental health (including people with dementia) - Requires Improvement

We carried out an announced comprehensive inspection at Partington Central Surgery on 20 February 2018 as part of our inspection programme.

At this inspection we found:

  • Safety concerns were not consistently identified or addressed in a timely manner. Reviews and learning from incidents were not thorough.
  • Information about services and how to complain was available but complaints were not used as an opportunity to learn and improve.
  • Risks to patients were not always assessed and appropriately managed.
  • Some audits had been carried out but there was no evidence that audits were driving improvements. Data showed patient outcomes were comparable with the local and national averages.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • Staff were aware of current evidence based guidance and had been trained to provide them with the skills and knowledge to deliver effective care and treatment. However staff had not received annual appraisals.
  • The practice offered 15 minute appointments 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.
  • Some of the staff we spoke with said they felt supported by management but there was a lack of structured governance and leadership within the practice.

The areas where the provider must make improvements are:

  • Ensure care and treatment is provided in a safe way to patients
  • Ensure there is an effective system for identifying, receiving, recording, handling and responding to complaints by patients and other persons in relation to the carrying on of the regulated activity
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

5th February 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the practice of Dr Salam J Farhan on 5 February 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 with an effective system for reporting and recording significant events. Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
  • Learning from incidents and events was evidenced but systems were not robust enough to ensure learning was always achieved.
  • 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.
  • 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 but negative comments by patients were not formally recorded and reviewed.
  • 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. Some negative comments were reported about the appointment system.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Following an unsettled period resulting in major staff changes, there was now 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.

Areas where the practice should make improvements :

  • Introduce a system to identify that communications have been received and learning has been achieved.

  • Encourage staff to report negative comments from patients to analyse trends and assess whether further investigation is required.

  • Introduce a formal process of regular documented clinical and other meetings.

  • Increase staff knowledge on what to do to help patients in vulnerable circumstances, such as homeless, domestic violence, travellers and/or those with language difficulties, if they presented.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice