We carried out an announced comprehensive inspection at Dr Amobi and Partners on 23 January 2019. 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 requires improvement overall.
We rated the practice as requires improvement for providing safe services because:
• The practice did not have clear systems and processes to keep patients safe. This included fire safety including training, sharps bins, vaccines fridge temperature monitoring, medicines management, significant events and reading and acting on patient safety alerts.
• The practice did not ensure that staff vaccinations was maintained in line with current Public Health England (PHE) guidance.
• Although there was guidance on identifying deteriorating or acutely unwell patients, some staff were not always aware of the responding to emergencies procedure.
• The practice did not have appropriate systems in place for the safe management of emergency medicines.
We rated the practice as good for providing effective services because:
• Staff had the skills, knowledge and experience to carry out their roles; however, monitoring was required to ensure that all clinicians had clear knowledge of evidence based guidelines.
• The practice was able to show that it always obtained consent to care and treatment.
• One of the GPs had a lead role at the Brent Centre for Young People, which provided support and counselling for young people with mental health issues.
• The practice worked together with other local practices in the community to provide education and support to the Somali community and to increase childhood immunisation uptake.
• Performance was mostly in line with local and national averages; however, some areas such as cancer screening rates and exception reporting required monitoring.
We rated the practice as good for providing caring services because:
• Staff treated patients with kindness, respect and compassion.
• Feedback from patients was mostly positive about the way staff treat people, although some patients highlighted issues with some staff attitude.
• The practice worked closely with their local food bank to support and identify vulnerable individuals or families that had not registered with a GP.
• Staff understood patients’ personal, cultural, social and religious needs.
• The practice gave patients timely support and information.
• The practices GP patient survey results were in line with local and national averages for questions relating to kindness, respect and compassion for consultations with GPs and nurses.
We rated the practice as good for providing responsive services because:
• The practice organised much of its services to deliver services to meet patients’ needs.
• Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
• There was no evidence from the meeting minutes provided that complaints were discussed and learning shared.
We rated the practice as requires improvement for providing well-led services because:
• The overall governance arrangements were ineffective. This related to safety systems and processes.
• The practice did not have clear and effective processes for managing risks, issues and performance.
The areas where the provider must make improvements are:
- Ensure that care and treatment is provided in a safe way.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
(Please see the specific details on action required at the end of this report).
The areas where the provider should make improvements are:
• Take action to update equipment calibration records. .
• Continue to monitor and improve on clinical indicators where performance is not as expected. This includes high areas of exception reporting, cancer screening and childhood immunisations.
• Continue to improve the identification of carers.
• Improve the complaints log to provide sufficient information and ensure wider learning from complaints is shared.
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