Archived: Dr Chittaranjan Pillai Also known as Plains View Surgery

Updated 23 April 2015

The practice of Dr Chittaranjan Pillai was originally founded in 1953 and moved to their current premises in 1988. The practice provides primary medical services to patients living in Mapperley, Nottingham and the surrounding suburbs.

A team of three GPs, a nurse practitioner, two practice nurses, a health care assistant, a practice and assistant practice manager and six receptionists and administrative staff provide care and treatment for approximately 5800 patients. One female and two male GPs provide care for patients at the practice. The practice does not provide an out-of-hours service to their own patients but patients are directed to the Nottingham Emergency Medical Service when the practice is closed.

We previously inspected this practice on 28 January 2014. At this inspection we found that the practice did not meet required standards in the care and welfare of people who use the service; supporting workers and assessing and monitoring the quality of service provision. We told the practice to take immediate action to address these issues.

We returned on 23 April and 24 May 2014 and found that required standards had still not been met for the care and welfare of people who use the service; supporting workers and assessing and monitoring the quality of service provision. In addition, we found that standards in staffing were also not being met. We met with stakeholders to discuss our concerns and to identify ways to support the practice in the changes they needed to make.

Updated 23 April 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Chittaranjan Pillai on 11 March 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for older people; people with long-term conditions; families, children and young people; working age people; people whose circumstances may make them vulnerable and people experiencing poor mental health.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by the management. The practice proactively sought feedback from staff and patients, which it acted on.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Introduce a system to ensure that GP prescription pads are handled in accordance with national guidance to enable them to be tracked through the practice. They should also introduce a robust system for the handling of manual repeat prescription requests to ensure there is an audit trail of the request and the changes made.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 April 2015

The practice is rated as good for the care of people with long-term conditions. The lead GP led in specialist clinical areas such as diabetes, heart disease and asthma and the practice nurses supported this work, which allowed the practice to focus on specific conditions. Practice nurses had received the additional training they required for the review of patients with long term conditions. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 23 April 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of Accident and Emergency attendances. Immunisation rates were high for all standard childhood immunisations. For example, data from NHS England showed the practice had achieved 100% uptake in seven of the 18 routine pre-school immunisations. This was above the regional average. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors.

Updated 23 April 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice worked closely with the patient participation group (PPG) to run a monthly Age UK desk in the practice for older people and their carers in the practice. A PPG is a group of patients registered with a practice who work with the practice to improve services and the quality of care.

Updated 23 April 2015

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. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group. The practice carried out cervical screening for women between the ages of 25 and 64 years. Their cervical screening uptake was 86% which was above the national target of 80%.

Updated 23 April 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All 38 patients with a diagnosis of dementia had a care plan in place that was reviewed annually. 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 how to access support groups such as MIND and SANE that provide care and emotional support for patients, their families and carers. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 23 April 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of vulnerable patients including those with a learning disability. It had carried out annual health checks for people with a learning disability and 95% of these patients had a personalised care plan in place. It offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. The PPG supported this work through the Age UK desk they ran in the practice by signposting patients who were socially isolated to support both within and outside of the practice. 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 normal working hours and out of hours