Background to this inspection
Updated
14 January 2019
Dr Naranammalpuram Srinivasan operates from The York Road Surgery close to the centre of Rotherham. The provider has recently changed their legal entity from an individual to a partnership and is in the process of changing their CQC registration to reflect this.
The practice has a Personal Medical Services (PMS) contract and serves a population of approximately 4,559 patients. The practice is situated in one of the most deprived areas in England and has a higher than average percentage of patients the 18 to 65 year old age group.
The practice operates from a two-storey, purpose built property, with all patient services provided on the ground floor.
The service is provided by a principle GP (male) and a male and female GP who have recently become partners and are applying for registration with CQC. Two sessional GPs (one male and one female), an advanced nurse practitioner (ANP), two practice nurses and a heath care assistant are also employed. The clinical team are supported by a practice manager, an administrator, a medical secretary and team of receptionists.
The York Road Surgery opens from 8am to 6.30pm Monday to Friday with extended hours being provided Tuesday 7am to 8am and Wednesday 7.30am to 8am which includes a combination of face to face or
and telephone consultations.
Early morning phlebotomy sessions are provided with the Practice Nurse on Tuesday and Wednesday 7.30am to 8am. The practice offers a range of book on the day and pre-bookable appointments during these hours.
The practice is registered to provide the flowing regulated activities:
- Family planning
- Treatment of disease, disorder or injury
- Surgical procedures
- Diagnostic and screening procedures
- Maternity and midwifery services
Updated
14 January 2019
This practice is rated as Good overall. (Previous inspection March 2018 - Requires Improvement and June 2015 – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Requires Improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Requires Improvement
Families, children and young people – Good
Working age people (including those recently retired and students) – Requires Improvement
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people living with dementia) - Good
We carried out an announced comprehensive inspection at Dr Naranammalpuram Srinivasan on 21 November 2018 to follow up on breaches of regulations.
At this inspection we found:
- The practice had improved systems to manage risk so that safety incidents were less likely to happen. For example, fire safety training had been provided and fire safety equipment had been regularly checked. However, we found two areas where action plans to minimise risk related to blind cords and hot water had not been implemented. When incidents did happen, the practice learned from them and improved their processes.
- The practice reviewed the effectiveness and appropriateness of the care it provided. Care and treatment was delivered according to evidence based guidelines. However, the practice’s performance on quality indicators for some long-term conditions and cancer indicators for working age people was significantly below local and national averages. Although some progress had been made there was limited improvement seen at the time of inspection.
- The recruitment policy and procedure had been reviewed and improved and pre-employment checks had been completed for recently employed staff.
- There was improvement in staff training and appraisal and systems to monitor staff training had been maintained.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were usually able to access care when they needed it but they reported limited access to pre-bookable appointments.
The areas where the provider should make improvements are:
- Minimise risk relating to blind cords and hot water.
- Develop and implement an infection prevention and control action plan to address shortfalls identified in the audit.
- Maintain records of the immunisation status for staff as per Department of Health Immunisation against infectious disease guidance (the Green Book).
- Review and risk assess the provision of emergency medicines.
- Review systems and processes to improve care and treatment related to patients long term conditions.
- Review systems and processes to improve uptake of cancer screening for working age patients.
- Review and improve systems for identifying carers.
- Review and improve the access to pre-bookable GP appointments.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.