Archived: Dr Awadh Jha

Updated 30 April 2015

Dr Awadh Jha provides primary medical services Monday to Friday from 8am to 6pm each week, with the local out of hours service providing cover between 12pm to 3pm each day. The practice does not operate extended opening hours. The practice is situated in Chatham, Kent with a branch surgery also in Chatham at the Luton Medical Centre and provides a service to approximately 2422 patients in the locality across the two practices.

Routine health care and clinical services are offered at the practice, led and provided by the GP. There are a range of patient population groups that use the practice which holds a primary medical services (PMS) contract with the Medway area clinical commissioning group (CCG). The practice does not provide out of hours services and information is available to patients about how to contact the local out of hours services provider.

There is one GP working at the practice, the GP is male and there are no options for seeing a female GP. There are no practice nurses employed at either practice and administration staff (female) work as health care assistants as required The practice has a number of administration / reception staff. The secretarial staff as well as a practice manager had left the practice in recent months and there had been no recruitment of staff to replace them.

The practice has more patients in the working age group than the local and national average and a higher number of older patients over the age of 65. The number of patients recognised as suffering deprivation is lower than the local and national average.

Services are delivered from:

Dr Awadh Jha

16 Tunbury Avenue

Walderslade

Chatham

Kent

ME5 9EH

And:

Luton Medical Centre

10a Beacon Hill

Chatham

Kent

ME5 7JX

Updated 30 April 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Awadh Jha on 11 November 2014. Overall the practice is rated as inadequate.

Specifically, we found the practice inadequate for providing safe, effective, responsive and well-led services. It was also inadequate for providing services for older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable, and for people experiencing poor mental health (including people with dementia). Improvements were also required for providing caring services.

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

• This practice is run with one GP only.

• The practice nurse had left the practice in recent months and there had been no recruitment of

staff to replace them.

• The secretarial staff as well as a practice manager had left the practice in recent months and

there had been no recruitment of staff to replace them.

• The practice was clean and patients told us they had no concerns with the cleanliness of the

practice.

• Patients were happy with the care treatment and support they had received. Patients told us they

had been involved and felt included in decisions about their care, treatment and support at the

practice.

• Patients were happy with the appointment system and said they could obtain an appointment

when they needed one and were able to get through to the practice on the telephone.

• The practice did not gather feedback from patients so that had the opportunity to improve or

influence the service they received and did not have a patient participation group (PPG).

The areas where the provider must make improvements are:

• Ensure the availability of appropriate medicines and equipment to deal with a medical

emergency.

• Ensure that medicines are stored correctly and safe to use.

• Protect patients and others who may be at risk of inappropriate or unsafe care and treatment, by

means of the effective operation of quality assessment and monitoring systems.

• Seek feedback from patients who use the service.

• Review their recruitment processes to help ensure that staff employed at the practice are safe to

work with vulnerable children and adults.

• Ensure sufficient numbers of suitably qualified, skilled persons are employed at the practice to

meet patient’s needs.

• Ensure that staff are up to date with mandatory training.

• Review staff records and ensure they are kept up to date.

• Revise patient records to help ensure they are up to date and contain key information such as

allergies, reactions to medicines and medical histories.

On the basis of the ratings given to this practice at this inspection, (and the concerns identified at a previous inspection on 29 October 2013), I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care we will take steps to cancel its registration with CQC.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

Updated 30 April 2015

The practice is rated as inadequate for the care of people with long-term conditions. There was a lack of robust assessment and monitoring of the quality of service provision. There were emergency processes and referrals made for patients in this group that had a sudden deterioration in health. When needed, longer appointments and home visits were available. Patients with complex conditions had an appropriate care plan developed. The practice offered pre-bookable appointments for a Saturday morning influenza vaccination clinic to patients in this population group.

Updated 30 April 2015

The practice is rated as inadequate for the care of families, children and young people. There was a lack of robust assessment and monitoring of the quality of service provision. The practice offered a full range of immunisations for children and influenza vaccinations. Last year’s performance for all immunisations was below the average for the clinical commissioning group (CCG). Two patients told us they were very satisfied with the antenatal care provided. The practice offered pre-bookable appointments for a Saturday morning influenza vaccination clinic to patients in this population group.

Updated 30 April 2015

The practice is rated as inadequate for care provided to older people. There was a lack of robust assessment and monitoring of the quality of service provision. The practice had a higher proportion of older patients compared to the clinical commissioning group (CCG) and national averages. Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. The practice offered proactive, personalised care to meet the needs of the older people in its patient population and had a range of enhanced services. For example, in dementia care. The practice offered pre-bookable appointments for a Saturday morning influenza vaccination clinic to patients in this population group. The practice was responsive to the needs of older people, including offering home visits and prioritised appointments for patients with complex needs. The practice had safeguarding policies and procedures to help identify patients at risk of abuse although not all staff had received safeguarding training.

Updated 30 April 2015

The practice is rated as inadequate for the care of working-age people (including those recently retired and students). There was a lack of robust assessment and monitoring of the quality of service provision. The practice had a lower proportion of patients between the ages of 20-39 years compared to other practices in the local CCG area.

The practice offered a range of health promotion and screening which reflected the needs for this patient population group. For example, the practice achieved 46% NHS health checks for 40-75 year old patients. The practice offered pre-bookable appointments for a Saturday morning influenza vaccination clinic to patients in this population group.

Updated 30 April 2015

The practice is rated as inadequate for the care of people experiencing poor mental health (including people with dementia). There was a lack of robust assessment and monitoring of the quality of service provision. 24 out of 34 patients with poor mental health had a care plan.

The practice had a system to follow up on patients who had been discharged from hospital to support them in the community.

Updated 30 April 2015

The practice is rated as inadequate for the care of people whose circumstances may make them vulnerable. There was a lack of robust assessment and monitoring of the quality of service provision. The practice held a register of patients living in vulnerable circumstances including those with learning disabilities. The practice had carried out annual health checks for people with learning disabilities and all of these patients had received a follow-up. The practice had sign-posted vulnerable patients to various support groups and third sector organisations. 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 and out of hours.