Dr Chitre & Dr Dasari's Surgery

We carried out an announced comprehensive inspection at Dr Chitre & Dr Dasari's Surgery on 10 and 11 July 2023. Overall, the practice is rated requires improvement.

Safe - requires improvement

Effective - requires improvement

Caring - good

Responsive - requires improvement

Well-led - requires improvement

Why we carried out this inspection

We carried out this inspection to provide a rating for the practice. The practice had not been inspected previously since its registration with CQC.

We inspected the following key questions:

• Safe
• Effective
• Caring
• Responsive
• Well-led

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A shorter site visit.

Our findings

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 found that:

• Some of the systems and processes the provider had developed to provide safe care, required improvement.
• Patients on high risk medicines or those patients on combinations of medicines that required more regular monitoring were not always monitored in line with guidelines.
• The provider could not demonstrate they had effective processes in place to manage repeat prescription requests or that patients had received effective medicine reviews.
• Patients with long term conditions were followed up in line with guidelines and the practice consulted with specialist services where required to provide more specialist treatment.
• The provider had effective systems to manage staff and training information.
• We saw that staff dealt with patients with kindness and respect.
• Despite their efforts to improve telephone access and appointment availability, the provider was aware that satisfaction with access to care and treatment remained low and further action was needed.
• The way the practice was led and managed did not always promote the delivery of high-quality, person-centre care, however, throughout the inspection process, the provider responded appropriately to our concerns and took immediate action to improve the quality and safety of services.

We found breaches of regulations. The provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards

The provider should:

• Improve methods used to communicate and engage with patients who do not attend for mental health reviews and appointments.
• Formalise clinical supervision arrangements with non-medical prescribers, so that formal audits are consistent and findings are shared with relevant staff.
• Improve systems so that patients are followed up after an acute exacerbation of asthma in line with national guidance to ensure they received appropriate care.
• Improve uptake of cancer screening including cervical cancer screening.
• Take action to involve patients and/or carers where necessary when completing care plans.
• Continue to take action to improve telephone and appointment access.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care