The Care Quality Commission
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  • GP practice

Archived: Dr Ashraf Zaman Also known as Dr Zaman's Surgery

Overall: Good read more about inspection ratings

2a Malzeard Road, Luton, Bedfordshire, LU3 1BD (01582) 481700

Provided and run by:
Dr Ashraf Zaman

All Inspections

13 June 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Zaman on 13 June 2017. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant and ‘near miss ‘events. However there was no analysis of trends.
  • Risks to patients were assessed and well managed.
  • The practice undertook appropriate recruitment checks including references and professional registration checks.
  • The practice had a comprehensive business continuity plan in place for major incidents.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were felt listened to and cared for 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. Improvements were made to the quality of care as a result of complaints and concerns.
  • 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 good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • We saw evidence of a strong patient centric culture and staff informed us that they were committed to provide high quality, personalised care for patients.
  • Staff we spoke to were knowledgeable with regard to their role and the changing needs of the patient population. They demonstrated a kind and caring attitude and were an asset to the clinical team.

The areas where the provider should make improvement are:

  • Implement a process to monitor trends from incidents, complaints and significant events.
  • Continue to identify and support carers.
  • Continue to encourage patients to attend national cancer screening programmes.
  • Establish a patient participation group (PPG) to ensure communication and feedback is sought from patients registered at the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

5 December 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced inspection of Dr Ashraf Zaman on 5 December 2014. This was a comprehensive inspection under Section 60 of the Health and Social Care Act (2008) as part of our regulatory functions. The practice achieved an overall rating of requires improvement. This was based on the safe, effective, responsive and well-led domains and six population groups we looked at achieving the same requires improvement rating.

Our key findings were as follows:

  • Patients reported good phone access to the practice.
  • Systems were in place to identify and respond to concerns about the safeguarding of adults and children.
  • We saw patients receiving respectful treatment from staff. Patients felt that their privacy and dignity was respected by polite and helpful staff.

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

Importantly, the provider must:

  • Ensure a coordinated approach to medicines management and that a system is in place to record the amount and type of medicines kept at the practice, keep them stored securely and within their expiry dates.
  • Ensure that systems designed to assess the risk of and to prevent, detect and control the spread of infection are fully implemented and audited.
  • Ensure adequate recruitment procedures are in place including completing the required background checks on staff and that the required information is available in respect of each person employed.
  • Ensure there is a recurring programme of clinical audit.
  • Ensure there are suitable arrangements in place to obtain and act in accordance with the consent of patients in relation to their care and treatment and that staff are knowledgeable about the process used. Ensure staff are trained in areas relevant to their roles, which may include details of the Mental Capacity Act (2005).
  • Ensure an appropriate system is in place for identifying, receiving, handling and responding appropriately to complaints made by patients.
  • Ensure that suitable arrangements are in place to obtain and have regard to the views and accounts of experiences of patients.
  • Ensure that suitable arrangements are in place to ensure that care and treatment is provided to all patients with regard to their cultural and language background.

In addition the provider should:

  • Ensure there is a complete annual process for the monitoring of and learning and improving from incidents and significant events.
  • Ensure staff are fully aware of the processes and policies they have lead responsibilities for. Staff should be informed and mindful of their own roles and responsibilities and those of their colleagues.
  • Ensure that clinical quality and effectiveness schemes such as the national Quality and Outcomes Framework (QOF) are used more extensively to improve patient outcomes. QOF is a national data management tool generated from patients’ records that provides performance information about primary medical services.
  • Ensure that all staff employed are supported by receiving appropriate supervision and appraisal.
  • Ensure the practice and the services available are fully accessible to those patients who may find attending in working hours difficult.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice