The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Ezekiel Alawale Also known as Lenton Medical Centre

Overall: Good read more about inspection ratings

266 Derby Road, Nottingham, Nottinghamshire, NG7 1PR (0115) 941 1208

Provided and run by:
Dr Ezekiel Alawale

All Inspections

15 September 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive follow up inspection at Dr Ezekiel Alawale on 15 September 2016. Overall the practice is rated as good.

We found improvements had been made since the previous inspection of October 2015 when the practice had been rated as inadequate and was placed into Special Measures.

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

  • Significant improvements had been made to the systems and processes in place which were highlighted following our October 2015 inspection. This included arrangements for delivering safe care and treatment, staffing and improved governance.
  • There was an open and transparent approach to safety and an effective system in place for reporting, recording and analysing significant events.
  • Risks to patients were assessed and mostly well managed through an on-going review programme to ensure patients and staff were kept safe. This included recruitment checks, health and safety, and medicines management.
  • However, a notice of deficiencies had been issued by the Nottinghamshire fire and rescue service in respect of fire safety contraventions found following their March and June 2016 visits; and a remedial notice had also been issued by the Nottingham City Clinical Commissioning Group (CCG). The two agencies will follow-up compliance in line with their enforcement framework and contractual agreements respectively. The practice had agreed to voluntary restrictions which included all patient and staff activities being undertaken on the ground floor.
  • Staff delivered care and treatment in line with evidence based guidance and local guidelines. The use of clinical audits contributed to improved patient care and outcomes.
  • The practice could demonstrate that they had made significant improvement in the Quality Outcomes Framework achievement because they had strengthened their recall system for inviting patients for health reviews.
  • Staff were supported with an induction, training, appraisal and supervision to cover the scope of their roles and meet their professional development needs.
  • The care of patients with complex health needs and / or living in vulnerable circumstances was co-ordinated with the wider multi-disciplinary team to deliver an integrated and responsive service.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Patients found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • Information about services and how to complain was available and easy to understand.
  • There was a clear leadership structure and staff felt supported by management.
  • Governance and performance management arrangements had been proactively reviewed to ensure improvements were sustained. This included the management of records, implementation of policies, administration of the practice and monitoring the overall service provision.

The areas where the provider must make improvement are:

  • Ensure fire safety measures continue to be regularly reviewed and embedded to demonstrate compliance with the fire safety regulations.

The areas where the provider should make improvement are:

  • The practice should continue to make efforts to identify and support carers within their patient population (including carers from black and ethnic minority community).

  • Ensure clear guidance is shared with staff regarding procedures for disposing uncollected prescriptions and the GP has clinical oversight to enable the monitoring of patients’ compliance with prescribed medicines

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

20 and 22 October 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Ezekiel Alawale’s practice on 20 and 22 October 2015. Overall the practice is rated as inadequate.

Specifically, we found the practice inadequate for providing safe and effective services and being well led. Improvements were also required for providing caring services. It was good for providing responsive services.

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

  • Patients were at risk of harm because systems and processes were not in place, implemented and / or embedded to keep them safe.

  • There was not always sufficient emergency equipment and medicines to ensure that staff could respond appropriately to medical emergencies.

  • Staff understood and fulfilled their responsibilities to raise concerns, report incidents and safeguard patients from harm.

  • Although staff assessed patients’ needs and delivered care in line with current evidence based guidance, some patient outcomes were below the local and national averages. Specifically, for people experiencing poor mental health and diabetes.

  • We saw limited evidence that audits were driving improvement in performance to enhance patient outcomes.

  • Suitable arrangements were not in place to ensure that appropriate recruitment checks had been undertaken and that all staff were regularly supported with appropriate induction, professional development and / or appraisals.

  • Most patients expressed a high level of satisfaction about the way the services were provided. However, data showed care planning arrangements required improvements.

  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

  • The practice had an active patient participation group. Patients were asked for their views and their feedback was acted on to improve the service.

  • The practice had a statement of purpose in place but no robust plans in place to address areas of concern and to ensure the delivery of safe care and treatment.

  • Staff felt supported by management although they were not all clear about their lead roles and those of others within the practice.

  • The overarching governance framework was not robust in terms of leadership skills and experience and there were a number of policies and procedures not implemented in practice

The areas where the provider must make improvements are:

  • Implement robust processes for effective governance arrangements including auditing systems that assess, monitor and drive improvement in the quality and safety of services provided. Specifically, health and safety risk assessments, monitoring of emergency medicines and equipment, and risks related to the premises and environment.

  • Ensure accurate, complete and contemporaneous records are maintained in respect of patients, staff employed and the management of the regulated activities.

  • Ensure recruitment arrangements include all necessary employment checks for all staff.

  • Provide all staff with induction, supervision, appraisals and the regular opportunity to explore individual training needs relevant to their role.

  • Clarify the lead roles and ensure there is leadership capacity to deliver all improvements.

In addition the provider should:

  • Carry out clinical audits and re-audits to improve patient outcomes.

  • Take action to address identified concerns with infection prevention and control practice.

  • Ensure written literature is available to help carers and patients understand the support services in place and the complaints system; including different languages and formats to meet the diverse needs of patients.

On the basis of the ratings given to this practice at this inspection, I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care we will take steps to cancel its registration with CQC.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

13 November 2013

During a routine inspection

During our visit we spoke with six patients, the provider, the practice manager and the practice nurse and four other staff.

Patients we spoke with said they were involved in their care and treatment options. Patients were happy with the care provided. One patient said, 'The doctor is fantastic here.' Another patient said, 'I trust all the staff here. The receptionists are friendly and helpful. They know me and my family and they care.' We observed members of staff interacting with patients in a friendly, polite and efficient manner.

We saw that procedures were in place to involve people in the surgery and to help monitor people's care needs. The staff were encouraged to develop their skills and undertake appropriate training to help deliver safe and effective care to patients. One member of staff said, 'It is a lovely place to work.' Another said, "We work well as a team."

Clinical records were well maintained however more could be done to ensure that other record management systems were effective.