Archived: Dr Bhupinder Batra

Dr Bhupinder Batra is a provider registered with CQC.

We carried out an inspection of the provider on 3 July 2019 to follow up concerns raised at our inspection on 20 February 2019. The practice was rated inadequate overall and put in special measures.

At the inspection in February 2019 we found that:

• The practice did not have clear systems and processes to keep patients safe.
• The practice did not have appropriate systems in place for the safe management of medicines.
• The practice did not have appropriate medicines and equipment for the safe management of medical emergencies.
• There was not an effective system in place to ensure all safety alerts were received and acted on.
• The practice did not ensure staff who required professional indemnity had this in place.
• The practice was unable to show that staff had the skills, knowledge and training to carry out their roles.
• The practice was unable to show that it always obtained consent to care and treatment.
• The provider had not ensured there were consistent systems to identify and follow up children living in disadvantaged circumstances and who were at risk.
• The practice had not ensured that exception reporting had been undertaken following assessment by a clinician.
• While the practice had a clear vision, that vision was not supported by a credible strategy.
• The overall governance arrangements were ineffective. The provider had not ensured that all staff had received essential training required to perform their role.
• The practice did not have clear and effective processes for managing risks, issues and performance.
• The practice did not always act on appropriate and accurate information.

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.

This inspection was an announced focused inspection carried out on 3 July 2019 as part of our inspection programme. This report covers our findings in relation to the actions we told the practice they should take to improve. Following the February 2019 inspection arrangements had been made for this service to merge with another service. While many steps had been taken towards the merger, at the time of this inspection the legally responsible provider remained the same.

At this inspection we found that:

• The practice had addressed most of the concerns identified in the Warning Notices and there was evidence of actions taken in response to concerns identified in the warning notices served on 13 March 2019.
• Risks associated with the premises, for example infection prevention and control, had either been addressed or were in the process of being addressed.
• Arrangements for managing the cold chain had improved and were managed in line with national guidelines.
• There was an effective system in place to ensure safety alerts were received and acted on.
• There were gaps in staff training. This was a concern identified at our last inspection.
• The provider had oversight to ensure clinical staff had the appropriate indemnity insurance in place.
• The provider had systems in place to ensure and check consent to care and treatment was sought in line with legislation and guidance and this was recorded.
• Governance arrangements had not improved as not all policies were operating as intended; the policy framework in place did not cover all areas of operation. For example, policies to monitor essential training for staff.
• It was not clear how the provider used data to monitor and improve performance. Exception reporting figures in relation to the Quality Outcomes Framework (QOF) we saw were very low.

The areas where the provider should make improvements are:

• Continue with work to monitor staff training and upgrade the premises in light of infection control audits.
• Review the policy framework to ensure all policies are operating as intended. For example, policies to monitor essential training for staff.
• Continue with planned activities to monitor and improve performance.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Please refer to the detailed report and the evidence tables for further information.

We carried out an announced comprehensive inspection at Dr Bhupinder Batra, also known locally as Waldron Family GP Practice on 20 February 2019. The practice was previously inspected on 22 July 2015, where they were rated as good for providing effective, caring, responsive and well-led services and good overall. However, the practice was rated as requires improvement for providing safe services. The full comprehensive report of the 22 July 2015 inspection can be found by selecting the ‘all reports’ link for Dr Bhupinder Batra on our website at .

This inspection was an announced comprehensive inspection carried out on 20 February 2019 as part of our inspection programme. This report covers our findings in relation to the actions we told the practice they should take to improve at our last inspection. This included:

• Sharing lessons learnt from incidents with all relevant staff.
• Undertaking a risk assessment to assure themselves the shared use of the AED equipment was sufficient and effective.
• Actively seek to involve patients in developing and improving the service.
• Implement systems to keep track of prescription pads.

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 have rated this practice as inadequate overall.

We rated the practice as inadequate for providing safe services because:

• The practice did not have clear systems and processes to keep patients safe.
• The practice did not have appropriate systems in place for the safe management of medicines.
• The practice did not have appropriate medicines and equipment for the safe management of medical emergencies.
• The practice did not ensure staff who required professional indemnity had this in place.

We rated the practice as requires improvement for providing effective services because:

• The practice was unable to show that staff had the skills, knowledge and training to carry out their roles.
• The practice was unable to show that it always obtained consent to care and treatment.
• The practice had not ensured that exception reporting had been undertaken following assessment by a clinician.

These areas affected all population groups so we rated all population groups as requires improvement.

We rated the practice as inadequate for providing well-led services because:

• The practice could not demonstrate that they had implemented actions to address the issues we told them they should take at the previous inspection on 22 July 2015. At this inspection we also identified additional concerns that put patients at risk.
• While the practice had a vision, that vision was not supported by a credible strategy.
• The overall governance arrangements were ineffective.
• The practice did not have clear and effective processes for managing risks, issues and performance.
• The practice did not always act on appropriate and accurate information.
• We saw little evidence of systems and processes for learning, continuous improvement and innovation.

We rated the practice as good for providing caring and responsive services because:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

The areas where the provider must make improvements are:

• 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 of care.

The areas where the provider should make improvements are:

• Review systems in place so minutes of meetings are recorded.
• Implement actions to improve the uptake for childhood immunisation and for the cancer screening programme.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

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

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice