Archived: Baring Road Medical Centre

Updated 27 May 2016

The practice of Dr Shashi Arora, also known as Baring Road Medical Centre, is based in the London Borough of Lewisham. The practice is run by one GP (female) who works full time at the practice and manages the site. The practice is a modern purpose built premises from which the practice has been based since 2008. The address of the practice is 282 Baring Road, Grove Park, London, SE12 0DS.

The practice is in an area with a mixed demographic, including areas of both relatively high and relatively low deprivation. The practice population is predominantly white English. However, the practice has in recent years seen an increase in population of white (other), mostly patients who are originally from Eastern European countries.

The practice has a list size of approximately 6,500. Further to the GP who runs the practice, there are three salaried GPs (two female and one male). In total 26 GP sessions are offered per week. There are also two practice nurses, one of who was a lead, and two healthcare assistants. There is also a practice manager and 12 other administrative and reception staff.

The practice is contracted to provide Personal Medical Services (PMS) and is registered with the CQC for the following regulated activities: treatment of disease, disorder or injury, family planning, surgical procedures, and diagnostic and screening procedures at one location.

The practice is open between 8:00am and 6:30pm Monday to Friday. The practice also had extended hours on Wednesday from 6:30pm until 8:00pm where appointments with a GP, nurse or healthcare assistant were all available. Scheduled appointments are available throughout the day apart from 1:00pm until 2:00pm daily for lunch, although a duty doctor is on call at this time in the event that a patient needs to see a GP as a matter of urgency.

The practice had been inspected in July 2014 under the CQCs previous inspection methodology. It had not been previously inspected under the new methodology.

Updated 27 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Shashi Arora’s practice (also known as Baring Road Medical Centre on 22 March 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, although the policy for managing such issues lacked specific detail.

• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.

• Patients said they found it difficult to make an appointment with a named GP and that routine appointments were not always immediately available. However, there were urgent appointments available the same day.

• 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 management. The practice proactively sought feedback from staff and patients, which it acted on in some cases.

• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• The practice should ensure that all clinical staff have DBS checks. If non-clinical staff are not DBS checked then a risk assessment as to why this is not required must be in place.

• The practice should review its appointments systems, and telephone answering service in line with feedback from patients that we spoke to, comment cards that we received and the national patient survey which said that telephone waits were long and appointments difficult to access.

• The practice should consider reviewing it’s diabetes management processes to seek ways to improve its patient outcomes in this area against national figures.

• The practice should ensure that the seats in the reception area are free from tears to ensure that they are not an infection control risk.

• The practice should ensure that floor covering on stairs are firmly attached so that in future they do not become a trip hazard.

• The practice should review it’s policies to ensure that they are thoroughly documented, specifically detailing how and when the policy should be used, and what actions should be taken. In particular the serious untoward events policy and fire prevention policies should be reviewed.

• The practice should look into ways of better identifying carers.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 27 May 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was lower than the CCG and national average. The practice had scored 71% in QOF with a total of 61of 86 points scored. The percentage of patients with diabetes, on the register, in whom the last IFCCHbA1c was 64 mmol/mol or less in the preceding 12 months was 67%, compared to a national average of 77%. The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less was 69% compared to a national average of 81%.

• Longer appointments and home visits were available when needed.

Updated 27 May 2016

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 A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 76%, which was comparable to the the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 27 May 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 27 May 2016

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.

Updated 27 May 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 74% of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average/ worse than the national average.

• Performance for mental health related indicators was similar to the CCG and national average. The practice had attained 81% of the available QOF points, scoring 21 of 26 points. The percentage of patients diagnosed with dementia whose care has been reviewed in a face-to-face review in the preceding 12 months was 74%, compared to a national average of 84%. A comprehensive care plan was in place for 80% of patients, compared to 79% within the CCG and 75% nationally.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 27 May 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• 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.