Archived: Dr Manohar Sohanpal Also known as Garlinge Practice

Updated 3 September 2015

Dr Manohar Sohanpal provides medical care Monday to Friday from 8am to 6.30pm each week day and operates extended opening hours from 7.30am on Friday mornings, and until 7.30pm on Monday evenings. The practice is situated in the coastal town of Westbrook, near Margate in Thanet, Kent and provides a service to approximately 3,800 patients in the locality.

Routine health care and clinical services are offered at the practice, led and provided by the GPs and nursing team. The practice has more patients aged between 5 and 18 years than both the local and national averages, although there are fewer children under the age of 4 registered at the practice than the local and national averages. There are a higher number of older people over the age of 85 registered at the practice than the national average, although there are fewer in this age group than the local average for the area. The number of patients in all age groups recognised as suffering deprivation for this practice is slightly lower than the local average, although significantly higher than the national average.

The practice is a single-handed GP provider (male), who employs one male salaried GP, a full-time female practice nurse, and a part-time female health care assistant. There are a total of six administration, secretarial and reception staff, a practice support manager and a practice / business manager.

The practice does not provide out of hours services to its patients and there are arrangements with another provider (the 111 service) to deliver services to patients when the practice is closed. The practice has a general medical services (GMS) contract with NHS England for delivering primary care services to local communities.

Services are delivered from:

150 Canterbury Road

Westbrook

Margate

Kent CT9 5DB

Updated 3 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Manohar Sohanpal on 5 March 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing effective, caring, responsive and well-led services. The practice was also rated good for providing services to older people, people with long-term conditions, families, children and young people, as well as working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia). The practice required improvement for providing safe services and the concerns which led to this rating applied to all population groups.

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles, with the exception of some areas of training that had not been updated or undertaken, although further training needs had been identified and training planned.
• 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.
• The practice was well equipped to treat patients and meet their needs.
• The practice was clean and there were systems to help ensure standards of hygiene were maintained.
• There was a clear leadership structure and the practice proactively sought feedback from staff and patients, which it acted on.

We saw an area of outstanding practice:

• The practice had worked with two other local practices to employ and provide a team of three specialist nurses and one health care assistant dedicated to supporting and responding to the needs of older patients over the age of 75. The team offered rapid response to meet urgent needs, as well as routine care and support. For example, they were notified and attended when patients were discharged from hospital, to assess and follow-up any additional needs. They had access to the patient records system and were therefore able to keep information accurate and up-to-date, including care plans that were used for these patients. Data we reviewed indicated that unplanned emergency attendance and admissions into hospital had reduced for this age group.

However there were areas of practice where the provider needs to make improvements.

The provider SHOULD:

• Review the training requirements for administration staff in relation to safeguarding vulnerable adults and children.
• Review the training requirements in relation to infection prevention and control for the lead nurse.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 September 2015

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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multi-disciplinary package of care.

Annual influenza vaccinations were routinely offered to patients with long-term conditions to help protect them against the virus and associated illness.

Updated 3 September 2015

The practice is rated as good for families, children and young people. Expectant mothers were referred and supported by the midwifery team and the GPs provided full post-natal care and six week baby checks.

The practice offered contraceptive clinics and advice, as well as sexual health screening and chlamydia testing for young people. There were systems to identify children who may be at risk and safeguarding procedures to help ensure concerns were followed up.

Immunisation rates were higher than the local averages for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 3 September 2015

The practice is rated as good for the care of older people. It offered proactive, personalised care to meet the needs of the older people in its patient population and had a range of enhanced services, for example, in avoiding unplanned admissions to hospital. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

The practice was caring in the support it offered to older people and there were effective treatments and on-going support for those patients identified with complex conditions, such as dementia and conditions associated with end of life care. All patients over the age of 75 had a named GP who was responsible for their care and treatment.

The practice had worked collaboratively with other local practices in the area to employ and provide a specialist community nursing team for patients over the age of 75, who responded to urgent and routine care needs to deliver multi-disciplinary services.

Annual influenza vaccinations were routinely offered to older people to help protect them against the virus and associated illness.

Updated 3 September 2015

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 patient population, those recently retired and students had been identified and the practice had adjusted the services it offered to help 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 reflected the needs for this age group.

Updated 3 September 2015

The practice was rated as good for the care of people experiencing poor mental health. The practice had procedures for identifying patients who had mental health needs. Regular checks and reviews were offered and follow-up contact was made where patients had not attended for appointments. The practice adopted a flexible approach in the support it offered, including offering same day appointments and had supported patients with routine weekly appointments to reduce their anxiety and to monitor their prescribed medicines. The practice also offered in-house counselling sessions on a regular basis.

The practice worked with multi-disciplinary teams and community specialists in providing support to patients with mental health needs and those with dementia, for example, the community mental health team and psychiatric services. Referrals to other services were made, including crisis support when needed.

Updated 3 September 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice was responsive in providing care in patients’ homes who found it difficult to attend the practice. The practice carried out annual health checks and offered longer appointments if required, for example, for patients who had a learning disability. The practice worked with multi-disciplinary teams in the case management of vulnerable patients and offered information about various support groups and voluntary organisations.

Practice staff knew how to recognise signs of abuse in vulnerable adults and children. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in and out of working hours.