Archived: Dr Shashi Arora Also known as Baring Road Medical Centre

Baring Road Medical Centre is a general medical practice in the London borough of Lewisham with a list of approximately 6,255 patients. The borough is characterised by relatively high levels of deprivation and is the 16th most deprived out of 326 local authorities in England. Life expectancy for both males and females is lower than the England average with early deaths due to heart disease, stroke and cancer.

We carried out an announced inspection on 7 July 2014. Our inspection team was led by a CQC Inspector, accompanied by two specialist advisors; a GP and a Healthcare Manager and an expert by experience. Before our inspection we reviewed a range of information we held about the practice from our Intelligent Monitoring System. We met with NHS England, NHS Lewisham Clinical Commissioning Group (CCG) and Healthwatch Lewisham and reviewed the information they gave to us. During our inspection we spoke with a range of staff including GP’s, nurses, a healthcare assistant and management and reception staff. We also spoke with patients and a representative from the practice’s patient participation group (PPG).

The practice was effective, caring, responsive and well-led. Improvements were required for the service to be safe. This was because disclosure and baring service (DBS) checks had not been undertaken for appropriate staff members, including non-clinical staff who are required to chaperone patients.

The practice had measures in place to protect and promote the safety of patients in their care. They had procedures for reporting, recording and learning from significant incidents. Staff completed safeguarding training and were aware of the processes to follow if they suspect a patient was at risk of harm. Vaccinations and other injectable medicines were stored correctly at the practice. Staff received infection control training and infection control audits were conducted. Staff were trained to deal with medical emergencies and emergency equipment and medicine was available.

Clinical staff attended weekly meetings to discuss complex medical cases and had access to up-to-date guidelines to ensure treatment was delivered in line with current best practices. The practice engaged in clinical audit to review services and to improve outcomes for patients. Staff received annual appraisal to review training needs and to promote further professional development. The practice had regular meetings with the wider multi-disciplinary team to develop integrated care pathways for their patients.

Patients considered that they are treated with dignity and respect by most staff at the practice. They described positive experiences with the care provided to them by clinical staff and that they were provided with relevant information and explanation about their treatment options.

Staff were aware of their responsibilities in assessing a patient’s capacity to make decisions about their care.

The practice met the needs of different population groups. For example, the practice had links with social services and community matron to provide holistic care for older people. Patients with long term conditions, people experiencing poor mental health and patients with learning disabilities were invited for annual reviews. Extended hour appointments were available weekly for patients unable to attend the practice in routine opening hours because of work commitments. The practice nurses offered immunisations to children and babies with good uptake rates.

There was a culture of discussion and learning at the practice and staff felt generally well supported by the management team. Patient feedback was gathered from the patient reference group (PPG) and patient surveys and there was evidence of improvements made to the service as a result of this feedback. The practice had a complaints policy and all complaints received in the previous year were reviewed at an annual meeting.  There was a contingency plan in place to manage any significant disruption to services.