Dr R Mapara and Partners Also known as Fernville

We carried out an announced comprehensive inspection at Dr R Mapara and Partners also known as Fernville Surgery, on 28 November 2018. The overall rating for the practice was good with the practice rated as requires improvement for being safe.

From the inspection on 28 November 2018, the practice was told they must:

• Ensure that care and treatment was provided in a safe way to patients.

This was because:

• The practice had not reviewed the prescribing of a specific medicine in line with evidence-based guidance.
• The system for storing blank prescriptions needed to be reviewed.

In addition, the practice was told they should:

• Review the system for storing prescriptions overnight so that these are safe.
• Ensure all staff were adequately trained in relation to identifying signs of sepsis.

After the comprehensive inspection, the practice submitted an action plan, outlining what they would do to meet the legal requirements in relation to the breach of regulations 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The full comprehensive report on the inspection carried out in November 2018 can be found by selecting the ‘all reports’ link for Dr R Mapara and Partners on our website at www.cqc.org.uk .

This inspection was an announced focused inspection at Dr R Mapara and Partners undertaken on 27 June 2019 to check that the practice had followed their plan and to confirm that they now met the legal requirements. This report only covers our findings in relation to those requirements.

We based our judgement of the quality of care at this service on a combination of:

• What we found when we inspected
• Information from our ongoing monitoring of data about services and
• Information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

Our key findings were:

• The practice had a process in place which ensured prescribed medicines were in line with evidence-based guidance. The process included the safe handling of requests for repeat prescriptions and structured medicines reviews for patients on repeat medicines.
• There were arrangements which ensured blank prescriptions were kept securely and their use monitored in line with national guidance.
• There was a system for recording and acting on safety alerts.
• Sepsis training had been delivered to all staff working at the practice.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection at Dr R Mapara & Partners on 28 November 2018 as part of our inspection programme.

At the last inspection in April 2015 we rated the practice as good overall.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

At this inspection we found:

• People who used the service were protected from avoidable harm and abuse.
• Patients’ needs were met by the way in which services were organised and delivered.
• The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.
• Feedback from patients was consistently positive and was higher than local and national averages.
• There was a strong person-centred culture.
• Staff we spoke with were committed to providing high quality care for patients and demonstrated a very caring approach to patient care, at times going above and beyond to meet the needs of more vulnerable patients.
• The practice worked closely with people who lived in a care setting and had strong, multi-disciplinary links to ensure that patients who were frail had advanced care plans in place which allowed them to choose their care and treatment.
• The practice worked closely with Community Navigators to assist patients in accessing local services within their community. They worked with vulnerable patients to assist them in ways which were not limited to their care and treatment needs at the practice in order to enable them to live healthily and more positive lives.
• There was a patient liaison manager at the practice who provided support for patients when they needed it. Staff were easily accessible and demonstrated a very compassionate and caring approach to patient care.
• The service worked closely with the local substance misuse service and met with them regularly. The lead GP worked with substance misuse patients within the practice and had strong links with local community support for this vulnerable group. Patients with no fixed abode were seen at the practice.

We rated the practice as requires improvement for providing safe services because:

• The practice had not reviewed the prescribing of a specific medicine in line with evidence-based guidance so that care and treatment was delivered safely.
• The system for storing blank prescriptions needed to be reviewed. The provider took action to address this following our inspection.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure that care and treatment is provided in a safe way to patients.

There were some areas where the provider should make improvements. These are:

• Review the system for storing prescriptions overnight so that these are safe.
• Ensure all staff were adequately trained in relation to identifying signs of sepsis.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice