Archived: Dr AK Abeyewardene

Updated 26 September 2016

Dr AK Abeyewardene is located in Grays, Essex. The practice  has a general medical services (GMS) contract with the NHS. There are approximately 4527 patients registered at the practice.

The practice is registered with the Care Quality Commission as a partnership, with two GP partners. There are three male GPs working at the practice, supported by a practice nurse. There is a practice manager and an assistant practice manager and seven administration members of staff who cover reception and clerical duties during the working week covering a variety of different hours.

The practice is open from Monday to Friday between the hours of 9am and 6.30pm and is closed on Thursday afternoons when primary medical services can be obtained from the out of hour’s provider, the South Essex Emergency Doctors Service.

The GP surgeries are available on Monday to Friday mornings between 9am and 11am, on Tuesday, Wednesday and Friday afternoons between 3pm and 5pm and on Friday afternoons between 4.30pm and 6.30pm. On Saturday and Sunday another healthcare provider has GP and nurse surgeries at a local hospital. Patients at this practice are able to book in advance, a limited number of consultations for the morning and afternoon surgeries. This is a facility shared by several other practices in the local area.

The practice has opted out of providing 'out of hours’ services which is now provided by the South Essex Emergency Doctors Service. Patients can also contact the non-emergency 111 service to obtain medical advice if necessary.

Updated 26 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr AK Abeyewardene on 27 November 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. They were analysed and areas for improvement identified and cascaded informally to staff working at the practice.
• All staff had received safeguarding training and understood the various types of abuse that could take place.
• Medicines alerts were being acted upon but there was a lack of an audit trail to reflect that appropriate action had been taken.
• The practice had a recruitment process but pre-employment checks were not consistently undertaken. Staff were suitably qualified and experienced and received an induction when first starting at the practice.
• Patients on high risk medicines were subject to regular review and monitoring.
• Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
• Staff were aware of relevant legislation in relation to consent including the Mental Capacity Act 2005.
• Clinical performance was monitored regularly and performance against targets was above national and local averages and had been consistently maintained over the last two years. All staff understood their roles and were involved in achieving healthcare objectives.
• Data available to us, feedback on CQC comment cards and information received from the patients we spoke with reflected that patients were satisfied with the services provided.
• The practice had a clear vision and had identified the objectives of the practice. This was not being discussed with staff.
• There was visible leadership and staff felt included and valued.

However there were areas where the provider must make improvements;

• Ensure an there are records to reflect that action has been taken in relation to medicines alerts.
• Ensure appropriate recruitment checks are consistently undertaken for all new members of staff in line with legislation and that regular checks are made to ensure clinical staff are registered with their professional body.
• Undertake health and safety and legionella risk assessments.
• Ensure that the system of monitoring the expiry dates of the first aid equipment is effective.

There were also areas where the provider should make improvements;

• Ensure cleaning checklists are in place and infection control audits are undertaken in line with guidance.
• Ensure the learning from complaints, significant events and safety issues are discussed with all staff and their views sought where relevant. Ensure that action taken as a result of identified improvements is recorded to provide an audit trail for completion.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 January 2016

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

• Nursing staff had lead roles in chronic disease management. Patients were monitored and received regular reviews of their health.
• An effective system was in place to review patients on high risk medicines for their condition to ensure they remained safe to prescribe.
• Longer appointments and home visits were available when needed. Vulnerable patients were identified and given priority appointments.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met.
• Patients with palliative care needs received support from a variety of healthcare professionals. Multidisciplinary meetings took place quarterly to discuss and plan the individual care and treatment needs of patients.
• Nursing staff had received specialist training to manage patients suffering from diabetes. Performance data reflected that the management of diabetes was higher than the national average.
• A system was in place to recall patients that required regular follow-up tests to manage their condition.

Updated 21 January 2016

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

• All staff had received appropriate training in safeguarding children and young people. A lead for safeguarding had been identified.
• Immunisation rates were above the national average all standard childhood immunisations.
• The practice provided cervical screening services for their patients and an effective recall and reminder system was in place. Cervical screening rates were above the national average.
• Ante and post-natal services were available for mothers and babies, including six week baby checks.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 21 January 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 responded to the needs of older people and offered same day appointments, home visits and telephone consultations.
• The nurse at the practice visited the homes of older patients for wound dressings, flu vaccinations and other services.
• Older patients identified as particularly vulnerable had care plans in place that were reviewed regularly, to avoid unnecessary hospital admissions.
• Multidisciplinary team meetings with other healthcare professionals took place every three months to review the care of vulnerable elderly patients.
• All staff had been trained in relation to the safeguarding vulnerable adults.
• An arrangement was in place with a local pharmacy to deliver prescriptions direct to patients at their home address.
• All patients over 75 had a named GP

Updated 21 January 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.
• Nurse led appointments were available for commuters to receive until 7.30pm on Monday evenings. GP appointments were available until 6.30pm on all weekdays.
• Patients could access GP and nurse appointments at a local hub providing primary care healthcare services.
• Students returning from university could register as temporary patients during term holidays.
• The practice offered a range of health promotion and screening that reflected the needs for this age group. Health checks were available for those patients over the age of 40.
• Smoking cessation clinics were available.

Updated 21 January 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• A register was in place and health reviews were carried out annually.
• Staff had a good understanding of how to support people with mental health needs and dementia.
• Longer appointments were made available for patients with mental health issues so time could be given to their health care needs.
• There was ready access to a mental health crisis team for those patients in distress.

Updated 21 January 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 regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice advised vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of safeguarding procedures.
• A three monthly multidisciplinary meeting took place to discuss the care and treatment needs of patients considered to be frail and may deteriorate rapidly.
• Carers or relatives were consulted about the care and treatment needs of patients after consent was obtained. Staff were aware of the Mental Capacity Act 2005 guidance in relation to the capacity to make decisions.
• Annual health checks took place for patients with learning disabilities and longer appointments were available.