The Care Quality Commission
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  • GP practice

Archived: Dr Mohammed Islam - Artane

Overall: Requires improvement read more about inspection ratings

1 Middleton Road, Manchester, Lancashire, M8 5DT (0161) 740 2785

Provided and run by:
Dr Mohammed Islam

All Inspections

5 January 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mohammed Islam– Artane Medical Centre on 5 January 2016. Overall the practice is rated as requires improvement.

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Although information about safety was recorded and discussed in meetings, the practice meetings did not have a clear process for acting on and reviewing significant event audits (SEAs) and near misses.
  • There was no policy or risk assessment in place, with no emergency medicines available onsite, with the exception of an anaphylaxis kit and oxygen.
  • Risks to patients were not fully assessed and well managed, for example there was no use of Patient Specific Directions (PSD) to enable the healthcare assistant to administer vaccinations safely to patients.
  • Patient confidentiality was not always assessed and managed.
  • The practice did not hold any records to show whether staff were immunised against infectious diseases for example Hepatitis B.
  • There was an inconsistent approach regarding infection control, medicines management and health and safety, with mixed responses from staff to who was responsible in the management of these areas.
  • Patients were positive about their interactions with staff and said they were treated with compassion and dignity.
  • Urgent appointments were available on the day, with children and vulnerable adults usually being seen within the hour.

The areas where the provider must make improvements are:

  • Ensure emergency medicines are available and monitored in the practice.
  • Ensure Patient Group Directions (PGD) and Patient Specific Directions (PSD) are implemented with support from the GP, where the nurse and healthcare assistants are administering vaccines.
  • Ensure processes for reporting, recording, acting on and monitoring of medicine management and infection control are in place.
  • Review and update all procedures and guidance to be a true reflection of the practice.
  • Ensure all clinical staff have their Hepatitis B status recorded
  • Ensure a safe practice environment is maintained, including assessment of all risks.

In addition the provider should:

  • Provide staff with training of the Safeguarding procedures.
  • Provide training for staff undertaking chaperone duties.
  • Provide a secure system for the monitoring of prescription pads
  • Staff to know how to access translation services.
  • Improve disabled access. We noted that the step outside did not have a ramp or bell to accommodate wheel chair users.

Where a practice is rated as inadequate for one of the five key questions or one of the six population groups the practice will be re-inspected within six months after the report is published. If, after re-inspection, the practice has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group, we will place the practice into special measures. Being placed into special measures represents a decision by CQC that a practice has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

25 September 2014

During an inspection in response to concerns

We undertook an inspection of the practice in response to information of concern we had received from NHS England and North Manchester Clinical Commissioning Group. We were made aware that Dr Islam had ceased to practice as a GP in May 2014. We wanted to know what arrangements were in place for continuing patient care, how and who was responsible for the day to day operation of the practice including clinical governance arrangements. We were told that the provider did not provide clinical care or clinical support but acted in the capacity of practice manager along with other members of staff.

31 October and 8 November 2013

During an inspection looking at part of the service

During our last inspection in July 2013 we had found that in five outcome areas the provider was not meeting the required standard. We asked the provider to take action and in this inspection we looked at those five outcome areas to see if improvements had been made.

At the time of our last inspection in July 2013 we found that four people used the service. We noted on this inspection that there was now only one person who used the service although until the week before our inspection there had been two.

We spoke with the one person who used the service who told us they had lived there for nine and a half years. This person told us they were happy and was well treated by staff.

We found that people's human rights had been respected and people had been given choices.

Care plans were well recorded and regularly updated to cater for people's needs.

We found that staff had received training in the safeguarding of vulnerable people. Systems were in place to highlight such incidents to the manager. We did note however that two safeguarding investigations against the provider had been upheld by the Local Authority. The Local Authority had made a referral to the Disclosure and Barring Service (DBS) in respect of these decisions. The home has now put plans in place to address this.

There were sufficient numbers of staff on duty to cope with the needs of the one person who used the service and systems were in place to monitor the quality of the service provided.

15, 17 July 2013

During a routine inspection

We spoke with all four people who lived at Artane during our inspection. We found that people spoke positively about the care home. People told us: "I've been here 5 and half years I'm 74 and waiting to die I'm OK here". 'I can only go upstairs at meal times and for medication'. 'I just read a lot and I enjoy reading'. 'We don't get taken on trips very often, but last year they took us to Blackpool, which I enjoyed because I got to see my cousin'. And 'I wish they would take us out'.

During our inspection we looked at all 16 outcome areas for Artane residential care home. We found that since our last inspection in November 2012 there had been significant improvements in many areas of the home, such as cooperating with other providers, management of medicines supporting workers and the management of complaints.

We still had some areas of concerns about the care and welfare of people who used the service although we did see some improvements.

You can see our judgements on the front page of this report.

5 July 2011

During an inspection in response to concerns

This was a responsive review following concerns raised from professional visitors regarding their concerns in respect of the quality of support provided to people who used the service and their living conditions.

We had also been notified by the Local Authority, that though they had provided support and guidance to the registered manager in order to develop the quality of the service for the benefit of service users, sufficient improvements had not been made. As a consequence the Local Authority had temporarily suspended their contract with the provider until the provider can demonstrate they can meet the standards set by the Local Authority. This means that the Local Authority will not place any new service users at the home until they are satisfied that the provider can maintain standards. To safeguard service users other placing Local Authorities have been notified of the action taken.

The Community Infection Control nurse informed us that at the most recent audit conducted in July 2011 the provider was failing to maintain adequate systems for infection prevention, control and cleanliness. This means that there were concerns about the way the home was kept clean.

We spoke to all service users living at the home on the day of the site visit. They were complimentary about the staff team and registered manager and were generally satisfied with the support they received. But when we talked with them about their routines, we found that meal times were rigid, designed more around staffing rotas than service user's individual requirements. We were told the teatime meal was between 4:00pm and 4:30pm to suit staffing hours. Service users also told us 'food is not as good as it used to be' and 'there was no choice with food'.

Professional visitors to the service had informed us that service users accommodated in the flats to the side of the main home do not have free and direct access to the main home at all times. Routines are such that people who use services are encouraged to leave the main home and go to their flat at 8pm and that the main door to the home is locked at 10pm. This means service users cannot gain entry to the main home until the morning without permission or reason.

Service users told us that they did not receive support to go out together as a group or individually to local venues to socialise, have day trips out or holidays. They told us that some staff members when they were on duty had started to walk with them "around the block". A professional visitor confirmed that there were no routine planned social events to support services integration into community. This means they did not receive sufficient support to enable them to learn and develop necessary and valuable skills for their future independent living where required, which includes learning to develop friendships, form lasting relationships and become part of and be valued within the local community.