Dr Michael Garas Mikhail Also known as Chepstow Gardens Medical Centre

Letter from the Chief Inspector of General Practice

This is a focused desk top review of evidence supplied by Dr Michael Garas Mikhail, for areas within the key question well-led. This review was completed on 15 December 2016.

Upon review of the documentation provided by the practice, we found the practice to be good in providing well-led services. Overall, the practice is rated as good.

The practice was previously inspected on 5 April 2016. The inspection was a comprehensive inspection under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (HSCA). At the inspection, the practice was rated overall as ‘good’. However, within the key question well-led an area was identified as ‘requires improvement’, as the practice was not meeting the legislation around patient dignity. The practice was issued a requirement notice under Regulation 10, Dignity and Respect.

At the inspection in April 2016, we found an area of concern in relation to unprofessional communication about patients between some staff members.

Other areas identified where the practice was advised they should make improvements included:

• Carry out regular fire evacuation drills.
• Complete a legionella risk assessment.
• Display notices in the waiting room advising patients of chaperoning and translation services available.
• Ensure staff appraisals are up to date.
• Implement a robust strategy to deliver the practice vision.

The practice supplied an action plan and a range of documents which demonstrated they are now meeting the requirements of Regulation 10 Dignity and Respect of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The practice also demonstrated improvement in the other areas identified in the report from April 2016 which did not affect ratings. These improvements have been documented in the well-led section, showing how the registered person has demonstrated continuous improvement since the full inspection.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at 8.30am on 5 April 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had adequate facilities and was equipped to treat patients and meet their needs although the premises were in need of an upgrade which the practice told us was being addressed.
• There was a clear leadership structure and most staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.
• However, we did find an area of serious concern in relation to unprofessional communication about patients between some staff members.

The areas where the provider must make improvement are:

• Service users must be treated with dignity and respect.

In addition the provider should:

• Carry out regular fire drills to ensure fire evacuation procedures are effective.
• Complete a legionella risk assessment.

• Display notices in the waiting room advising patients of chaperoning and translation services available.
• Ensure staff appraisals are up to date.
• Implement a robust strategy to deliver the practice vision.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice