Dr Momosir Ali Also known as Parkfield Surgery

Updated 3 April 2017

Dr Momosir Ali, known also as ‘Parkfield Surgery’ is based in a purpose built facility in St Helens. There were 2,600 patients on the practice list at the time of inspection. The practice is based in a more deprived area when compared to other practices nationally. The male life expectancy for the area is 75 years compared with the CCG averages of 78 years and the national average of 79 years. The female life expectancy for the area is 80 years compared with the CCG averages of 82 years and the national average of 83 years.

The practice has one male GP who is the sole provider and one male salaried GP. The practice has one practice nurse, a health care assistant, a practice manager, reception and administration staff.

The practice is open Monday, Tuesday, Wednesday and Friday from 8.30am-1pm and from 2pm-6pm. On Thursdays the practice is open from 8.30am-1pm. Patients requiring GP services outside of normal working hours are referred on to the St Helens Rota who are the local out of hour’s provider.

The practice has a General Medical Services (GMS) contract. In addition the practice carried out enhanced services such as health assessments for patients with a learning disability.

Updated 3 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Momosir Ali on 22 February 2016. The full comprehensive report on the February 2016 inspection can be found by selecting the ‘all reports’ link for Dr Momosir Ali on our website at www.cqc.org.uk.

At our previous inspection in February 2016 we rated the practice as ‘good’ overall but as ‘requires improvement’ for safety as we identified three breaches of regulation. This was because improvements were needed to; the staff recruitment procedures, to staff training and to make information about the complaints process available to patients.

This inspection visit was carried out on 3 March 2017 to confirm that the provider had carried out their plan to meet the legal requirements in relation to the breaches. This report covers our findings in relation to that and additional improvements made since our last inspection.

The findings of this inspection were that the provider had taken action to meet the requirements of the last inspection and the service is now rated as ‘good’ for providing safe services. Our key findings were as follows:

• Pre-employment checks for new staff were carried out in line with requirements.

• Staff had been provided with the training they required for their roles and responsibilities. This included the provision of training, since our last inspection, in topics such as: health and safety, fire safety, infection control, safeguarding and the Mental Capacity Act 2015 and Deprivation of Liberty Safeguards (DoLS).

• Information about how to make a complaint was readily available for patients to access.

We also found that the provider had made a number of improvements to the service in response to recommendations we made at our last inspection. These included;

• A process had been introduced to share the learning from significant events. This included significant events being discussed at regular staff meetings.

• A system had been introduced to account for and securely store blank prescriptions.

• Action had been taken to ensure that all Patient Group Directions (written directives for the administration of medicines to a pre-defined group of patients without them having to see a prescriber directly) had been appropriately authorised by a GP.

• A supply of oxygen had been obtained for supporting patients in a medical emergency.

• All referrals to secondary care were now made electronically thereby reducing the margin for error in the referrals process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 May 2016

The practice is rated as good for the care of people with long-term conditions.

• Staff had lead roles in chronic disease management. The practice kept up to date registers of patients’ health conditions and arranged regular reviews around each patient’s birth date.

• Longer appointments and home visits were available when needed.

• For those patients with complex needs, the staff worked with Macmillan nurses to deliver a package of multidisciplinary care.

• The practice had identified patients who were at risk of unplanned hospital admissions and supported these patients to stay well at home.

Updated 17 May 2016

The practice is rated as good for the care of families, children and young people.

• The lead GP provided prompt involvement with safeguarding case reviews and with requests for information. Staff worked closely with health visitors.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test has been performed in the preceding 5 years was comparable with national data.

• The premises were suitable for children and babies and the practice

• The practice had in-house post-natal clinics, 6-8 week baby checks and weekly children’s immunisation clinics. Any child not attending appointments were followed up by the practice staff.

• Children were given same day appointments if needed.

Updated 17 May 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. All patients over 75 years had a named GP. Dementia assessments were carried out in house.

• Health checks were provided for patients over 75 years and referrals made to any necessary services. The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice identified military veterans and arranged longer appointments for them.

Updated 17 May 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 and offered continuity of care. The practice had introduced access to telephone consultations each day and extended appointment times over lunch time.

• The practice was proactive in offering online services such as booking appointments and ordering prescriptions.

• Health checks and health education were offered to patients between 40-74 years of age to promote patient well-being and address any health concerns.

Updated 17 May 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 95.24% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is above the national average. They had identified 18 patients with dementia.

• The practice had supported patients experiencing poor mental health offering guidance on how to access various support groups including bereavement counselling. They also offered in-house wellbeing nurse appointments.

• Most staff demonstrated a good understanding of issues around patient consent. However not all staff had received updated training in the Mental Capacity Act 2005.

Updated 17 May 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice supported patients living in circumstances that could make them vulnerable including patients who were homeless.

• Annual health checks were provided for patients with learning disabilities and extended appointment times were offered.

• The practice informed vulnerable patients about how to access various support groups and supported patients with food bank vouchers when needed.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing and how to contact relevant agencies in normal working hours and out of hours.

• Staff used translation services to assist patients who did not have English as their first language. Deafness and hard of hearing patients were offered the services of an interpreter service via the deafness resource centre.