Archived: Dr Pradeep Sahadevan Also known as Sahadevan

Updated 1 March 2017

The practice is situated in the city of Plymouth. The practice provides a general medical service to approximately 800 patients of a diverse age group.

Information published by Public Health England rates the level of deprivation within the practice population group as five on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

Park View Surgery is an extremely small practice with only one male GP, and one female practice nurse. They are supported by a practice manager, and one member administrative staff. A female locum GP is used if the GP provider is not available.

Patients using the practice also have access to community nurses, mental health teams and health visitors. Other health care professionals visit the practice on a regular basis. The practice is open between theNHS contracted opening hours of8.30am and6.00pm Monday to Friday. Extended hours are offered on Mondays between 6.00 and 7.00 pm.

In addition to pre-bookable appointments can be booked up to four weeks in advance, telephone consultations are offered as the first mode of access, and same day appointments are made as required. Outside of these times patients are directed to contact the Devon Doctors out of hour’s service by using the NHS 111 number.

The practice has a General Medical Service (GMS) contract.

The practice provides regulated activities from its primary location at 34 Ford Park Road, Plymouth, PL4 6NX.

Updated 1 March 2017

Letter from the Chief Inspector of General Practice

Previously we carried out an announced comprehensive inspection at Dr Pradeep Sahadevan (Park View Practice) on 6 July 2016. The overall rating for the practice was good but required improvements in the safe domain. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Dr Pradeep Sahadevan ( Park View Surgery) on our website at www.cqc.org.uk .

This inspection was an announced focused inspection carried out on 2 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 6 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At our previous inspection on 6 July 2016, we rated the practice as good overall but required improvement for providing safe services as the arrangements in respect of ensuring appropriate, safe processes were not fully in place. For example;

• Emergency medicines were not fully in place;

• Risk assessments had not been completed for fire, Legionella or emergency equipment;

• Other areas such as audits, patient dignity and chaperoning, identifying carers, sourcing training and updating the business continuity plan also required improving.

These arrangements had improved when we undertook a follow up inspection on 2 February 2017. The practice is now rated as good for providing safe services.

Our key findings were as follows:

The arrangements in respect of ensuring appropriate, safe processes had improved. The practice had systems in place for the management and dispensing of medicines, which kept patients safe. The practice had a small kit of medicines for use in acute allergic reactions in addition to emergency medicines which could be used at the practice or used when visiting patients at home.

Risks to patients, staff and visitors to the practice were assessed and plans were in place. The practice had conducted a fire risk assessment, a legionella risk assessment, and there was a risk assessment in place to qualify why there was no defibrillator for the use in the event of an emergency.

Regular medicines audits, to ensure prescribing was in accordance with best practice guidelines for safe prescribing had been carried out.

We saw privacy curtains were in place around the couch in the GP consulting room to maintain patients’ privacy and dignity during examinations, investigations and treatments.

We saw information on chaperoning was displayed for patients in the reception area and in the GPs room.

The practice manager informed us that she was still in the process of sourcing mental capacity act training but was hopeful this would be in the very near future. We saw posters displayed in clinical rooms providing information for staff of the five principles of the act and what action to take.

The practice had identified those patients that were carers and were making sure this information was able to be seen clearly on the clinical system. The practice was very small with only approximately 800 patients and only eight of those being active carers.

The practice manager had updated the business contingency plan to include what action was to be taken when covering staff absences.

However, there were areas of practice where the provider should continue to make improvements.

Importantly, the provider should:

• Continue to review the types of audits carried out;

• Continue to review training for staff;

• Continue to review the business continuity plan.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 August 2016

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

• Longer appointments and home visits were available when needed.

• All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The practice had good relationships with members of the community teams. For example, they liaised well with the other professionals to support those patients with chronic diseases so they were able to avoid unplanned hospital admissions.

• The practice maintained registers and provided appointments for patients with long term conditions. QOF results indicated an efficient management of chronic disease management.

• The practice nurse attended regular educational updates to make sure their knowledge and skills were up to date of long term conditions such as diabetes and respiratory disease.

• There was a long term conditions book which could be borrowed from reception for patients to use for advice and management on their disease. This was advertised on the PPG noticeboard.

Updated 11 August 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 87%, which was higher than the clinical commissioning group (CCG) average of 83% and the national average of 82%.

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

• Chlamydia testing kits and condoms were available for patients to take without asking to promote patient privacy.

Updated 11 August 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 patients in its population. All patients over 75 had a named GP. The most vulnerable frail elderly had care plans in place.

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

• Monthly meetings were held where patients at risk of unplanned admission were discussed and plans made for good coordinated care. These plans were agreed with the patient.

Updated 11 August 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 11 August 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of patients 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. For example patients were signposted to the local Timebank initiative, which is where people share their skills to help others.

• 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 were caring and patient but not all staff had received training on the Mental capacity Act 2005.

Updated 11 August 2016

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

• At the time of the inspection the practice had no patients registered who had a learning disability, were homeless or were travellers.

• The practice offered longer appointments for patients that needed it.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations. For example the local alcohol advice service and self-referral process was advertised in the waiting room for patients with alcohol addiction so that they could access support and treatment.

• 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.